Dr Jacob David Martin, DMD is a medicare enrolled "Dentist - General Practice" provider in Kronenwetter, Wisconsin. His current practice location is
1851 County Road Xx, Kronenwetter, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(715) 359-0550.
Dr Jacob David Martin is licensed to practice in Wisconsin (license number 6001570-15) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1700578697.
Healthcare Provider's Profile
Full Name | Dr Jacob David Martin |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 1851 County Road Xx, Kronenwetter, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1700578697
- Provider Enumeration Date: 05/22/2023
- Last Update Date: 07/22/2024
Medicare PECOS Information:
- PECOS PAC ID: 1850832007
- Enrollment ID: I20240916002201
Medical Identifiers
Medical identifiers for Dr Jacob David Martin such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1700578697 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 6001570-15 (Wisconsin) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jacob David Martin allows following entities to bill medicare on his behalf.
Entity Name | Cedar Creek Dental Wi, S.c. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1447279625 PECOS PAC ID: 5698057370 Enrollment ID: O20170113001087 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jacob David Martin is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Jacob David Martin, DMD 820 Glade Ct Apt 11, Kronenwetter, WI 54455-7333 Ph: (423) 710-6078 | Dr Jacob David Martin, DMD 1851 County Road Xx, Kronenwetter, WI 54455-7933 Ph: (715) 359-0550 |
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