Mary Amanda Jacobs, MD | |
200 Scenery Dr., State College, PA 16801-5602 | |
(814) 231-4560 | |
(814) 231-6246 |
Full Name | Mary Amanda Jacobs |
---|---|
Gender | Female |
Speciality | Micrographic Dermatologic Surgery (mds) |
Experience | 21 Years |
Location | 200 Scenery Dr., State College, Pennsylvania |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811973894 | NPI | - | NPPES |
ENROLLED | Medicaid | IA | |
102337081 | Medicaid | PA | |
699485700 | Medicaid | MN | |
P00333407 | Other | MN | RAILROAD MEDICARE |
35163500 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | 46763 (Minnesota) | Secondary |
207ND0101X | Dermatology - Mohs-micrographic Surgery | MD437386 (Pennsylvania) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Geisinger Medical Center | Danville, PA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Geisinger Clinic | 5395657001 | 2841 |
Entity Name | Geisinger Clinic |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366493868 PECOS PAC ID: 5395657001 Enrollment ID: O20040130000518 |
Entity Name | Dubois Dermatology And Cosmetics Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225419666 PECOS PAC ID: 8022324003 Enrollment ID: O20150908000183 |
Mailing Address | Practice Location Address |
---|---|
Mary Amanda Jacobs, MD 100 N Academy Ave, Danville, PA 17822-4903 Ph: (570) 271-6144 | Mary Amanda Jacobs, MD 200 Scenery Dr., State College, PA 16801-5602 Ph: (814) 231-4560 |
Timothy David Mckinley, Dermatology Medicare: Medicare Enrolled Practice Location: 200 Scenery Dr, State College, PA 16801 Phone: 814-231-4560 Fax: 814-231-6246 | |
Dr. Cassandra Joy Simonetta, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 32 Colonnade Way, State College, PA 16803 Phone: 814-272-4445 Fax: 814-272-4450 | |
Jerry Forrest Mikesell, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1393 N Atherton St, State College, PA 16803 Phone: 814-238-6097 Fax: 814-238-5527 | |
Dr. Loretta A Pratt, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1850 E Park Ave, Suite 312, State College, PA 16803 Phone: 814-237-6600 Fax: 814-237-5383 | |
Mark Edward Kozminsky, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 2505 Green Tech Dr, Suite A1, State College, PA 16803 Phone: 814-237-6600 Fax: 814-237-5383 | |
Dr. Matthew Allyn Hazey, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 100 Scenery Dr Uppr Level, State College, PA 16801 Phone: 814-237-6600 Fax: 814-237-5383 |