Dr Lisa Maria Jacob, MD is a medicare enrolled "Plastic Surgery" physician in Wilkes Barre, Pennsylvania. She went to Rutgers New Jersey Medical School and graduated in 2002 and has 22 years of diverse experience with area of expertise as Plastic And Reconstructive Surgery. She is a member of the group practice St Luke's Physician Group Inc and her current practice location is
675 Baltimore Drive, Wilkes Barre, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at
(570) 808-6400.
Dr Lisa Maria Jacob is licensed to practice in Pennsylvania (license number MD452576) 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 1700077237.
Physician's Profile
| Full Name | Dr Lisa Maria Jacob |
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| Gender | Female |
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| Speciality | Plastic And Reconstructive Surgery |
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| Experience | 22 Years |
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| Location | 675 Baltimore Drive, Wilkes Barre, Pennsylvania |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Lisa Maria Jacob attended and graduated from Rutgers New Jersey Medical School in 2002
NPI Data:
- NPI Number: 1700077237
- Provider Enumeration Date: 08/08/2007
- Last Update Date: 08/11/2020
Medicare PECOS Information:
- PECOS PAC ID: 5698845527
- Enrollment ID: I20141031000080
Medical Identifiers
Medical identifiers for Dr Lisa Maria Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1700077237 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208200000X | Plastic Surgery | 25MA08245300 (New Jersey) | Secondary |
| 208200000X | Plastic Surgery | 24109 (West Virginia) | Secondary |
| 208200000X | Plastic Surgery | MD452576 (Pennsylvania) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| St Luke's Physician Group Inc | 6709798333 | 1727 |
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 Lisa Maria Jacob allows following entities to bill medicare on her behalf.
| Entity Name | Geisinger Clinic |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366493868
PECOS PAC ID: 5395657001
Enrollment ID: O20040130000518 |
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| Entity Name | St Lukes Physician Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1700984622
PECOS PAC ID: 6709798333
Enrollment ID: O20040226000062 |
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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 Lisa Maria 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 Address | Practice Location Address |
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Dr Lisa Maria Jacob, MD
100 N Academy Ave,
Danville, PA 17822-4903
Ph: (570) 271-6144 | Dr Lisa Maria Jacob, MD
675 Baltimore Drive,
Wilkes Barre, PA 18702-3306
Ph: (570) 808-6400 |
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