Jacqueline Deborah Weidauer, CNP-BC is a medicare enrolled "Nurse Practitioner" physician in Sioux Falls, South Dakota. Her current practice location is
1600 W 22nd St, Sioux Falls, South Dakota. You can reach out to her office (for appointments etc.) via phone at
(605) 312-1000.
Jacqueline Deborah Weidauer is licensed to practice in South Dakota (license number CP001487) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1548737018.
Physician's Profile
Full Name | Jacqueline Deborah Weidauer |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Location | 1600 W 22nd St, Sioux Falls, South Dakota |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1548737018
- Provider Enumeration Date: 11/01/2018
- Last Update Date: 10/12/2021
Medicare PECOS Information:
- PECOS PAC ID: 4587062849
- Enrollment ID: I20211018001685
Medical Identifiers
Medical identifiers for Jacqueline Deborah Weidauer such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1548737018 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2080N0001X | Pediatrics - Neonatal-perinatal Medicine | CP001487 (South Dakota) | Secondary |
363L00000X | Nurse Practitioner | CP001487 (South Dakota) | 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. Jacqueline Deborah Weidauer allows following entities to bill medicare on her behalf.
Entity Name | Sanford Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1396764254 PECOS PAC ID: 0244143824 Enrollment ID: O20031110000532 |
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Entity Name | Sanford Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1093090342 PECOS PAC ID: 8325950215 Enrollment ID: O20040115000388 |
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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. Jacqueline Deborah Weidauer 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 |
Jacqueline Deborah Weidauer, CNP-BC Po Box 5074, Sioux Falls, SD 57117-5074 Ph: () - | Jacqueline Deborah Weidauer, CNP-BC 1600 W 22nd St, Sioux Falls, SD 57105-1521 Ph: (605) 312-1000 |
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