Thomas V Jackson, MD - Medicare Emergency Medicine in Portage, WI

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Thomas V Jackson, MD is a medicare enrolled "Emergency Medicine" physician in Portage, Wisconsin. His current practice location is 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (608) 742-4131.

Thomas V Jackson is licensed to practice in Wisconsin (license number 21269020) 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 1700862992.

Contact Information

Thomas V Jackson, MD
2817 New Pinery Rd, Divine Savior Healthcare Inc,
Portage, WI 53901-9257
(608) 742-4131
(608) 745-5173

Map and Direction




Physician's Profile

Full NameThomas V Jackson
GenderMale
SpecialityEmergency Medicine
Location2817 New Pinery Rd, Portage, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1700862992
  • Provider Enumeration Date: 12/20/2005
  • Last Update Date: 01/30/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 4587797378
  • Enrollment ID: I20100730000306

Medical Identifiers

Medical identifiers for Thomas V Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1700862992NPI-NPPES
30128500MedicaidWI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 21269020 (Wisconsin)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. Thomas V Jackson allows following entities to bill medicare on his behalf.
Entity NameDivine Savior Healthcare Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124083894
PECOS PAC ID: 5799684007
Enrollment ID: O20040225000909

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. Thomas V Jackson 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 AddressPractice Location Address
Thomas V Jackson, MD
Po Box 387, Divine Savior Healthcare Inc,
Portage, WI 53901-0387

Ph: (608) 742-4131		Thomas V Jackson, MD
2817 New Pinery Rd, Divine Savior Healthcare Inc,
Portage, WI 53901-9257

Ph: (608) 742-4131

Reviews and Comments


Emergency Medicine Doctors in Portage, WI

Terra Thimm,
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2817 New Pinery Rd, Portage, WI 53901
Phone: 608-742-4131    
Michael C Walters, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 2817 New Pinery Rd, Portage, WI 53901
Phone: 608-745-5689    Fax: 608-742-6098
James T Gariti Sr., MD
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, WI 53901
Phone: 608-742-4131    Fax: 608-742-6098
Gregory S Keeling, MD
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, WI 53901
Phone: 608-742-4131    Fax: 608-745-5173
Jennifer Marie Bahr, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 2817 New Pinery Rd, Divine Savior Healthcare, Inc., Portage, WI 53901
Phone: 608-742-4131    Fax: 608-745-5173
Mr. Brian T. Stubitsch, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, WI 53901
Phone: 608-742-4131    Fax: 608-742-6098
Hythem Abad, DO
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2817 New Pinery Rd, Portage, WI 53901
Phone: 608-742-4131    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.