Jaclyn Dubois, CNM is a medicare enrolled "Midwife" in Sun City West, Arizona. Her current practice location is
14502 W Meeker Blvd, Sun City West, Arizona. You can reach out to her office (for appointments etc.) via phone at
(623) 524-4000.
Jaclyn Dubois is licensed to practice in Massachusetts (license number RN2281225) 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 1033760624.
Provider's Profile
| Full Name | Jaclyn Dubois |
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| Gender | Female |
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| Speciality | Midwife |
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| Location | 14502 W Meeker Blvd, Sun City West, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1033760624
- Provider Enumeration Date: 09/24/2019
- Last Update Date: 10/31/2024
Medicare PECOS Information:
- PECOS PAC ID: 2466886619
- Enrollment ID: I20191223001247
Medical Identifiers
Medical identifiers for Jaclyn Dubois such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1033760624 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367A00000X | Advanced Practice Midwife | CNM05705 (Utah) | Secondary |
| 176B00000X | Midwife | RN2281225 (Massachusetts) | 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. Jaclyn Dubois allows following entities to bill medicare on her behalf.
| Entity Name | Arizona Maternity And Womens Clinic Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1568632933
PECOS PAC ID: 0749349637
Enrollment ID: O20081106000711 |
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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. Jaclyn Dubois 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 |
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Jaclyn Dubois, CNM
3200 S 600 E,
Salt Lake City, UT 84106-1218
Ph: (978) 495-2607 | Jaclyn Dubois, CNM
14502 W Meeker Blvd,
Sun City West, AZ 85375-5282
Ph: (623) 524-4000 |
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