Jacob David Daigle, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Amery, Wisconsin. His current practice location is
265 Griffin St E, Amery, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(715) 268-8000.
Jacob David Daigle is licensed to practice in Wisconsin (license number 1107533-30) 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 1215501218.
Provider's Profile
| Full Name | Jacob David Daigle |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 265 Griffin St E, Amery, Wisconsin |
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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: 1215501218
- Provider Enumeration Date: 05/14/2021
- Last Update Date: 09/30/2024
Medicare PECOS Information:
- PECOS PAC ID: 0042669723
- Enrollment ID: I20231206002081
Medical Identifiers
Medical identifiers for Jacob David Daigle such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1215501218 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 1107533-30 (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. Jacob David Daigle allows following entities to bill medicare on his behalf.
| Entity Name | Aspirus Rhinelander & Tomahawk Hospitals & Clinics Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1144991340
PECOS PAC ID: 9335059856
Enrollment ID: O20031126000706 |
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| Entity Name | North American Partners In Anesthesia Wisconsin Sc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1720733454
PECOS PAC ID: 8729475447
Enrollment ID: O20220428000422 |
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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. Jacob David Daigle 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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Jacob David Daigle,
25102 Thornridge Dr,
Grand Blanc, MI 48439-9277
Ph: (715) 573-8692 | Jacob David Daigle,
265 Griffin St E,
Amery, WI 54001-1439
Ph: (715) 268-8000 |
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