Carla Jacob, in Baltimore, MD - Medicare Nurse Practitioner

Carla Jacob, is a medicare enrolled "Nurse Practitioner - Family" in Baltimore, Maryland. Her current practice location is 22 S Greene St, Baltimore, Maryland. You can reach out to her office (for appointments etc.) via phone at (347) 268-4390.

Carla Jacob is licensed to practice in Maryland (license number R248512) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1497063010.

Contact Information

	Carla Jacob,
	22 S Greene St, Baltimore, MD 21201-1544
	(347) 268-4390
	Not Available

Map and Direction

Provider's Profile

Full Name	Carla Jacob
Gender	Female
Speciality	Nurse Practitioner - Family
Location	22 S Greene St, Baltimore, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1497063010
Provider Enumeration Date: 09/16/2010
Last Update Date: 08/24/2023

Medicare PECOS Information:

PECOS PAC ID: 0547522336
Enrollment ID: I20180314000802

Medical Identifiers

Medical identifiers for Carla Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1497063010	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WS0200X	Registered Nurse - School	542089 (New York)	Secondary
363LF0000X	Nurse Practitioner - Family	340624 (New York)	Secondary
363LF0000X	Nurse Practitioner - Family	R248512 (Maryland)	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. Carla Jacob allows following entities to bill medicare on her behalf.

Entity Name	Expert Medical Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1215019377 PECOS PAC ID: 4284651738 Enrollment ID: O20051025000233

Entity Name	Fpa Hospital Based
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1629319413 PECOS PAC ID: 4789826694 Enrollment ID: O20130806000185

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. Carla 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
Carla Jacob, 22 S Greene St, Baltimore, MD 21201-1544 Ph: (347) 268-4390	Carla Jacob, 22 S Greene St, Baltimore, MD 21201-1544 Ph: (347) 268-4390

Reviews and Comments

Nurse Practitioner Nurses in Baltimore, MD

Ms. Lindsay Bream O'meara, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 22 S Greene St, Suite S4d07, Baltimore, MD 21201 Phone: 410-328-3365
Mrs. Tamara Jeanne Setola, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7001 Johnnycake Rd Ste 101, Baltimore, MD 21244 Phone: 410-719-0063
Alison C Eissler, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 312 N. Martin Luther King Jr. Blvd, Suite 102, Baltimore, MD 21201 Phone: 610-716-0192
Mrs. Rebecca Delaney Tsao, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 98 North Broadway, Suite 421, Baltimore, MD 21231 Phone: 410-955-6211
Kamishia Latasha Thomas, ANP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 601 N Caroline Street, Baltimore, MD 21264 Phone: 443-997-0270 Fax: 410-614-1168
Dana Aybout, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4940 Eastern Avenue, Baltimore, MD 21264 Phone: 410-550-5568 Fax: 410-550-0470
Andrew Brave, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2401 W Belvedere Ave, Baltimore, MD 21215 Phone: 410-601-9000

Carla Jacob, - Medicare Nurse Practitioner in Baltimore, MD