Dr Andrew Jacob Polk, MD is a medicare enrolled "Ophthalmology" physician in Fenton, Missouri. His current practice location is
1011 Bowles Ave Ste 200, Fenton, Missouri. You can reach out to his office (for appointments etc.) via phone at
(636) 717-1700.
Dr Andrew Jacob Polk is licensed to practice in Missouri (license number 2024032606) 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 1528697448.
Physician's Profile
| Full Name | Dr Andrew Jacob Polk |
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| Gender | Male |
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| Speciality | Ophthalmology |
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| Location | 1011 Bowles Ave Ste 200, Fenton, Missouri |
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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: 1528697448
- Provider Enumeration Date: 04/02/2020
- Last Update Date: 09/30/2024
Medicare PECOS Information:
- PECOS PAC ID: 5799109963
- Enrollment ID: I20240829003948
Medical Identifiers
Medical identifiers for Dr Andrew Jacob Polk such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1528697448 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207W00000X | Ophthalmology | 2024032606 (Missouri) | 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 Andrew Jacob Polk allows following entities to bill medicare on his behalf.
| Entity Name | Envision Eye Specialists Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205072360
PECOS PAC ID: 0042375941
Enrollment ID: O20090210000052 |
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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 Andrew Jacob Polk 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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Dr Andrew Jacob Polk, MD
1011 Bowles Ave Ste 200,
Fenton, MO 63026-2384
Ph: (636) 717-1700 | Dr Andrew Jacob Polk, MD
1011 Bowles Ave Ste 200,
Fenton, MO 63026-2384
Ph: (636) 717-1700 |
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