Jaclyn Noel Marie Jezak, CNP in Fremont, OH - Medicare Nurse Practitioner

Jaclyn Noel Marie Jezak, CNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Fremont, Ohio. She graduated from nursing school in 2021 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Memorial Professional Services Ltd, Promedica Central Physicians and her current practice location is 710 Cleveland Ave, Fremont, Ohio. You can reach out to her office (for appointments etc.) via phone at (419) 334-6619.

Jaclyn Noel Marie Jezak is licensed to practice in Ohio (license number APRN.CNP.0030241) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1922764760.

Contact Information

	Jaclyn Noel Marie Jezak, CNP
	710 Cleveland Ave, Fremont, OH 43420-3224
	(419) 334-6619
	Not Available

Map and Direction

Provider's Profile

Full Name	Jaclyn Noel Marie Jezak
Gender	Female
Speciality	Nurse Practitioner
Experience	3 Years
Location	710 Cleveland Ave, Fremont, Ohio
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Jaclyn Noel Marie Jezak graduated from nursing school in 2021

NPI Data:

NPI Number: 1922764760
Provider Enumeration Date: 11/16/2021
Last Update Date: 11/03/2023

Medicare PECOS Information:

PECOS PAC ID: 3072906643
Enrollment ID: I20220202001870

Medical Identifiers

Medical identifiers for Jaclyn Noel Marie Jezak such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1922764760	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	APRN.CNP.0030241 (Ohio)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Memorial Professional Services Ltd	1456531870	37
Promedica Central Physicians	2365348190	827

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 Noel Marie Jezak allows following entities to bill medicare on her behalf.

Entity Name	Promedica Central Physicians
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043270150 PECOS PAC ID: 2365348190 Enrollment ID: O20031211000226

Entity Name	Memorial Professional Services Ltd
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1205139623 PECOS PAC ID: 1456531870 Enrollment ID: O20110202000164

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 Noel Marie Jezak 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
Jaclyn Noel Marie Jezak, CNP 4300 Champlin Dr, Perrysburg, OH 43551-7178 Ph: (419) 266-5297	Jaclyn Noel Marie Jezak, CNP 710 Cleveland Ave, Fremont, OH 43420-3224 Ph: (419) 334-6619

Reviews and Comments

Nurse Practitioner Nurses in Fremont, OH

Elizabeth A. Gabel, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1479 N River Rd, Fremont, OH 43420 Phone: 419-355-9440 Fax: 419-355-9443
Amy Jo Mitchell, APRN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2221 Hayes Ave, Fremont, OH 43420 Phone: 419-334-3869
Briana Lynn Rauch, FNP, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 715 S Taft Ave, Fremont, OH 43420 Phone: 419-332-7321
Robin Kathleen Rosipko, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1479 N River Rd, Fremont, OH 43420 Phone: 419-355-9440 Fax: 419-355-9443
Trisha D Hamm, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Walk In Urgent Care, 2180 Sean Dr., #6b, Fremont, OH 43420 Phone: 419-355-8343 Fax: 419-355-8617
Jessica Ann Carroll, MSN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2281 Hayes Ave, Fremont, OH 43420 Phone: 419-355-8488
Ms. Kelly Jean Buckles, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1479 N River Rd, Fremont, OH 43420 Phone: 419-355-9440 Fax: 419-626-9443

Jaclyn Noel Marie Jezak, CNP - Medicare Nurse Practitioner in Fremont, OH