Mr Jacob Wayne Moss, MD, JD is a medicare enrolled "General Practice" physician in Driggs, Idaho. He went to Southern Illinois University School Of Medicine and graduated in 2013 and has 11 years of diverse experience with area of expertise as General Practice. He is a member of the group practice Teton Valley Health Care Inc and his current practice location is
283 N 1st St, Driggs, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 354-2302.
Mr Jacob Wayne Moss is licensed to practice in Idaho (license number M-14547) 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 1205179751.
Physician's Profile
Full Name | Mr Jacob Wayne Moss |
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Gender | Male |
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Speciality | General Practice |
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Experience | 11 Years |
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Location | 283 N 1st St, Driggs, Idaho |
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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:
- Mr Jacob Wayne Moss attended and graduated from Southern Illinois University School Of Medicine in 2013
NPI Data:
- NPI Number: 1205179751
- Provider Enumeration Date: 04/03/2013
- Last Update Date: 08/22/2022
Medicare PECOS Information:
- PECOS PAC ID: 0042454159
- Enrollment ID: I20191231002364
Medical Identifiers
Medical identifiers for Mr Jacob Wayne Moss such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1205179751 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | TM190 (Georgia) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
208D00000X | General Practice | M-14547 (Idaho) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Teton Valley Health Care Inc | 3870744956 | 25 |
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. Mr Jacob Wayne Moss allows following entities to bill medicare on his behalf.
Entity Name | Teton Valley Health Care Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1013264183 PECOS PAC ID: 3870744956 Enrollment ID: O20121128000587 |
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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. Mr Jacob Wayne Moss 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 |
Mr Jacob Wayne Moss, MD, JD 241 Harvard Ave, Rexburg, ID 83440-2210 Ph: (208) 313-1438 | Mr Jacob Wayne Moss, MD, JD 283 N 1st St, Driggs, ID 83422-5109 Ph: (208) 354-2302 |
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