Jason Keith Fackler, ARNP is a medicare enrolled "Nurse Practitioner - Acute Care" physician in Louisville, Kentucky. His current practice location is
201 Abraham Flexner Way Ste 1105, Louisville, Kentucky. You can reach out to his office (for appointments etc.) via phone at
(502) 367-4500.
Jason Keith Fackler is licensed to practice in Kentucky (license number 3019095) 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 1609564566.
Physician's Profile
| Full Name | Jason Keith Fackler |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Acute Care |
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| Location | 201 Abraham Flexner Way Ste 1105, Louisville, 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: 1609564566
- Provider Enumeration Date: 04/28/2023
- Last Update Date: 09/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 1850296310
- Enrollment ID: I20230612002454
Medical Identifiers
Medical identifiers for Jason Keith Fackler such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1609564566 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207RC0000X | Internal Medicine - Cardiovascular Disease | APRN11026036 (Florida) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | 3019095 (Kentucky) | 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. Jason Keith Fackler allows following entities to bill medicare on his behalf.
| Entity Name | Cardiothoracic & Vascular Surgical Associates Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1851403125
PECOS PAC ID: 5395725188
Enrollment ID: O20040722000541 |
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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. Jason Keith Fackler 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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Jason Keith Fackler, ARNP
Po Box 909,
Louisville, KY 40201-0909
Ph: (502) 367-4500 | Jason Keith Fackler, ARNP
201 Abraham Flexner Way Ste 1105,
Louisville, KY 40202-3841
Ph: (502) 367-4500 |
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