Christian Jacob Pemberton, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Newport, Kentucky. His current practice location is
1400 Grand Ave, Newport, Kentucky. You can reach out to his office (for appointments etc.) via phone at
(859) 301-5901.
Christian Jacob Pemberton is licensed to practice in Kentucky (license number 58963) 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 1639705619.
Physician's Profile
| Full Name | Christian Jacob Pemberton |
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| Gender | Male |
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| Speciality | Psychiatry & Neurology - Psychiatry |
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| Location | 1400 Grand Ave, Newport, Kentucky |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1639705619
- Provider Enumeration Date: 03/21/2020
- Last Update Date: 06/26/2024
Medicare PECOS Information:
- PECOS PAC ID: 2860932878
- Enrollment ID: I20240905000989
Medical Identifiers
Medical identifiers for Christian Jacob Pemberton such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1639705619 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2084P0800X | Psychiatry & Neurology - Psychiatry | 58963 (Kentucky) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
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. Christian Jacob Pemberton allows following entities to bill medicare on his behalf.
| Entity Name | Summit Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1508287640
PECOS PAC ID: 2163326240
Enrollment ID: O20031120000738 |
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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. Christian Jacob Pemberton 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 |
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Christian Jacob Pemberton, MD
Po Box 635283,
Cincinnati, OH 45263-5283
Ph: (859) 301-5901 | Christian Jacob Pemberton, MD
1400 Grand Ave,
Newport, KY 41071-2570
Ph: (859) 301-5901 |
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