Mr Michael Blake Jacob, PA-C is a medicare enrolled "Physician Assistant" physician in Plymouth, Minnesota. He graduated from medical school in 2017 and has 7 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Allina Health System and his current practice location is
2855 Campus Dr, Plymouth, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(763) 577-7000.
Mr Michael Blake Jacob is licensed to practice in Minnesota (license number 12593) 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 1821502154.
Physician's Profile
| Full Name | Mr Michael Blake Jacob |
|---|
| Gender | Male |
|---|
| Speciality | Physician Assistant |
|---|
| Experience | 7 Years |
|---|
| Location | 2855 Campus Dr, Plymouth, Minnesota |
|---|
| 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 Michael Blake Jacob graduated from medical school in 2017
NPI Data:
- NPI Number: 1821502154
- Provider Enumeration Date: 11/22/2017
- Last Update Date: 03/11/2021
Medicare PECOS Information:
- PECOS PAC ID: 8022377647
- Enrollment ID: I20180105000060
Medical Identifiers
Medical identifiers for Mr Michael Blake Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1821502154 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207XX0005X | Orthopaedic Surgery - Sports Medicine | 12595 (Minnesota) | Secondary |
| 363A00000X | Physician Assistant | 12593 (Minnesota) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Allina Health System | 4587573613 | 3101 |
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 Michael Blake Jacob 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 Michael Blake Jacob, PA-C
5600 Camerata Way Unit 221,
St Louis Park, MN 55416-5285
Ph: (612) 590-3809 | Mr Michael Blake Jacob, PA-C
2855 Campus Dr,
Plymouth, MN 55441-2649
Ph: (763) 577-7000 |
Reviews and Comments