Jesse John Susa, MD in Black River Falls, WI

Jesse John Susa, MD is a medicare enrolled "Family Medicine" physician in Black River Falls, Wisconsin. He went to University Of Minnesota Medical School and graduated in 2016 and has 8 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Black River Memorial Hospital Inc, Krohn Clinic Ltd and his current practice location is 610 W Adams St, Black River Falls, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (715) 284-1867.

Jesse John Susa is licensed to practice in Wisconsin (license number 69790-20) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1477901395.

Contact Information

	Jesse John Susa, MD
	610 W Adams St, Black River Falls, WI 54615
	(715) 284-1867
	Not Available

Map and Direction

Physician's Profile

Full Name	Jesse John Susa
Gender	Male
Speciality	Family Practice
Experience	8 Years
Location	610 W Adams St, Black River Falls, Wisconsin
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Jesse John Susa attended and graduated from University Of Minnesota Medical School in 2016

NPI Data:

NPI Number: 1477901395
Provider Enumeration Date: 06/01/2016
Last Update Date: 07/26/2024

Medicare PECOS Information:

PECOS PAC ID: 4082906649
Enrollment ID: I20190801002090

Medical Identifiers

Medical identifiers for Jesse John Susa such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1477901395	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	69790-20 (Wisconsin)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
St Croix Hospice	Eau claire, WI	Hospice
Black River Memorial Hospital	Black river falls, WI	Hospital
Meadowbrook Of Black River Falls	Black river falls, WI	Nursing home

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Black River Memorial Hospital Inc	3173431178	44
Krohn Clinic Ltd	3577464916	20

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. Jesse John Susa allows following entities to bill medicare on his behalf.

Entity Name	Krohn Clinic Ltd
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790777621 PECOS PAC ID: 3577464916 Enrollment ID: O20040119000050

Entity Name	Black River Memorial Hospital Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811940331 PECOS PAC ID: 3173431178 Enrollment ID: O20040128000517

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. Jesse John Susa 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
Jesse John Susa, MD 610 W Adams St, Black River Falls, WI 54615-9110 Ph: (715) 284-1867	Jesse John Susa, MD 610 W Adams St, Black River Falls, WI 54615 Ph: (715) 284-1867

Reviews and Comments

Family Medicine Doctors in Black River Falls, WI

Kirk Lane, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 610 W Adams St, Black River Falls, WI 54615 Phone: 715-284-4311 Fax: 715-284-2568
Delbert W Rogers, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 610 W Adams St, Black River Falls, WI 54615 Phone: 715-284-4311 Fax: 715-284-2568
Jeffrey K Polzin, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 610 W Adams St, Black River Falls, WI 54615 Phone: 715-284-4311 Fax: 715-284-2568
Dr. Stephanie L Bantell, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 610 W Adams St, Black River Falls, WI 54615 Phone: 715-284-4311 Fax: 715-284-0475
Dr. Sarah June Busse, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 610 W Adams St, Black River Falls, WI 54615 Phone: 715-284-4311 Fax: 715-284-2568
Carol A Martin, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 711 W Adams St, Black River Falls, WI 54615 Phone: 715-284-5361 Fax: 715-284-1390
Neil Francis Cox, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: N6520 Lumberjack Guy Rd, Black River Falls, WI 54615 Phone: 715-284-9851 Fax: 715-284-5150

Jesse John Susa, MD - Medicare Family Practice in Black River Falls, WI