Lisa Rebecca Jolly, DDS - Medicare Dentist in Chicago, IL

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Lisa Rebecca Jolly, DDS is a medicare enrolled "Dentist - Oral And Maxillofacial Surgery" provider in Chicago, Illinois. Her current practice location is 225 E Chicago Ave, Chicago, Illinois. You can reach out to her office (for appointments etc.) via phone at (312) 227-4000.

Lisa Rebecca Jolly is licensed to practice in Utah (license number 12328725-9921) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1205419355.

Contact Information

Lisa Rebecca Jolly, DDS
225 E Chicago Ave,
Chicago, IL 60611-2991
(312) 227-4000
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameLisa Rebecca Jolly
GenderFemale
SpecialityDentist - Oral And Maxillofacial Surgery
Location225 E Chicago Ave, Chicago, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1205419355
  • Provider Enumeration Date: 05/05/2021
  • Last Update Date: 09/22/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 6709280621
  • Enrollment ID: I20210813001358

Medical Identifiers

Medical identifiers for Lisa Rebecca Jolly such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1205419355NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
122300000XDentist 12328725-9921 (Utah)Secondary
1223S0112XDentist - Oral And Maxillofacial Surgery 12328725-9921 (Utah)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. Lisa Rebecca Jolly allows following entities to bill medicare on her behalf.
Entity NameUniversity Of Utah Dental Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1346633203
PECOS PAC ID: 0244542595
Enrollment ID: O20150630001141
Entity NameUniversity Of Utah Pediatric Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487018974
PECOS PAC ID: 0547552473
Enrollment ID: O20160713000371

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. Lisa Rebecca Jolly 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 AddressPractice Location Address
Lisa Rebecca Jolly, DDS
30 N 1900 E # 3b400,
Salt Lake City, UT 84132-0002

Ph: (801) 581-8419		Lisa Rebecca Jolly, DDS
225 E Chicago Ave,
Chicago, IL 60611-2991

Ph: (312) 227-4000

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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