Chris Jacob, DO - Medicare Student in an Organized Health Care Education/Training Program in Saint Clair Shores, MI

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Chris Jacob, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Saint Clair Shores, Michigan. His current practice location is 24211 Little Mack Ave, Saint Clair Shores, Michigan. You can reach out to his office (for appointments etc.) via phone at (586) 498-0440.

Chris Jacob is licensed to practice in Michigan (license number 5151009894) 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 1790163962.

Contact Information

Chris Jacob, DO
24211 Little Mack Ave,
Saint Clair Shores, MI 48080-1151
(586) 498-0440
(586) 498-0401

Map and Direction




Physician's Profile

Full NameChris Jacob
GenderMale
SpecialityStudent In An Organized Health Care Education/training Program
Location24211 Little Mack Ave, Saint Clair Shores, Michigan
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1790163962
  • Provider Enumeration Date: 05/08/2015
  • Last Update Date: 06/29/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 0749595908
  • Enrollment ID: I20241203000776

Medical Identifiers

Medical identifiers for Chris Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1790163962NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208M00000XHospitalist 293779 (New York)Secondary
390200000XStudent In An Organized Health Care Education/training Program 5101021621 (Michigan)Secondary
207R00000XInternal Medicine 5101021621 (Michigan)Secondary
390200000XStudent In An Organized Health Care Education/training Program 5151009894 (Michigan)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. Chris Jacob allows following entities to bill medicare on his behalf.
Entity NameMclaren Northern Michigan
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760736094
PECOS PAC ID: 9931018181
Enrollment ID: O20040415001193

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. Chris Jacob 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
Chris Jacob, DO
601 Elmwood Ave Box Med,
Rochester, NY 14642-0001

Ph: (585) 275-4912		Chris Jacob, DO
24211 Little Mack Ave,
Saint Clair Shores, MI 48080-1151

Ph: (586) 498-0440

Reviews and Comments



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).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.