Dr Jacquelyn Geraldine Small, DO in Fort Wayne, IN

Dr Jacquelyn Geraldine Small, DO is a medicare enrolled "Family Medicine" physician in Fort Wayne, Indiana. She went to Michigan State University College Of Osteopathic Medicine and graduated in 2019 and has 5 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Covenant Medical Center Inc, Henry Ford Macomb Hospital Corporation and her current practice location is 3909 New Vision Dr, Fort Wayne, Indiana. You can reach out to her office (for appointments etc.) via phone at (260) 469-6610.

Dr Jacquelyn Geraldine Small is licensed to practice in Indiana (license number 02007766A) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1225694102.

Contact Information

	Dr Jacquelyn Geraldine Small, DO
	3909 New Vision Dr, Fort Wayne, IN 46845-1725
	(260) 469-6610
	(260) 969-3065

Map and Direction

Physician's Profile

Full Name	Dr Jacquelyn Geraldine Small
Gender	Female
Speciality	Family Practice
Experience	5 Years
Location	3909 New Vision Dr, Fort Wayne, Indiana
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Jacquelyn Geraldine Small attended and graduated from Michigan State University College Of Osteopathic Medicine in 2019

NPI Data:

NPI Number: 1225694102
Provider Enumeration Date: 05/15/2019
Last Update Date: 09/03/2024

Medicare PECOS Information:

PECOS PAC ID: 3476889874
Enrollment ID: I20220504002121

Medical Identifiers

Medical identifiers for Dr Jacquelyn Geraldine Small such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225694102	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	5101025847 (Michigan)	Secondary
207Q00000X	Family Medicine	02007766A (Indiana)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Henry Ford Home Health Care	Detroit, MI	Home health agency
Henry Ford Macomb Hospital	Clinton township, MI	Hospital
Henry Ford Hospital	Detroit, MI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Covenant Medical Center Inc	2769387778	383
Henry Ford Macomb Hospital Corporation	7911808381	285

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 Jacquelyn Geraldine Small allows following entities to bill medicare on her behalf.

Entity Name	Henry Ford Health System
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134144801 PECOS PAC ID: 0547178311 Enrollment ID: O20031105000139

Entity Name	Covenant Medical Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972590412 PECOS PAC ID: 2769387778 Enrollment ID: O20031209000107

Entity Name	Henry Ford Macomb Hospital Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134265986 PECOS PAC ID: 7911808381 Enrollment ID: O20040119000142

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 Jacquelyn Geraldine Small 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 Jacquelyn Geraldine Small, DO 11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701 Ph: () -	Dr Jacquelyn Geraldine Small, DO 3909 New Vision Dr, Fort Wayne, IN 46845-1725 Ph: (260) 469-6610

Reviews and Comments

Family Medicine Doctors in Fort Wayne, IN

Rebecca Mason, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8233 Glencarin Blvd, Fort Wayne, IN 46804 Phone: 260-425-5470 Fax: 260-425-5475
Anthony D Dennis, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 11635 Coldwater Rd, Fort Wayne, IN 46845 Phone: 260-637-1661 Fax: 260-637-1601
Dr. Charles R Pattan, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 11050 Parkview Circle Dr, Fort Wayne, IN 46845 Phone: 833-724-8326 Fax: 260-266-8941
Gregory L Chupp, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 3909 New Vision Dr, Fort Wayne, IN 46845 Phone: 260-469-6610
Christina Mcguirk, Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 2200 Randallia Dr, Fort Wayne, IN 46805 Phone: 260-373-4000
Dr. Mary Ann O'brien, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3909 New Vision Dr, Fort Wayne, IN 46845 Phone: 260-496-6602 Fax: 260-969-3065
Brian A. Adams, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2512 E Dupont Rd Ste 200, Fort Wayne, IN 46825 Phone: 260-458-3760 Fax: 260-458-3761

Dr Jacquelyn Geraldine Small, DO - Medicare Family Practice in Fort Wayne, IN