Jacob Dougherty, AGACNP-BC - Medicare Nurse Practitioner in Centerville, OH

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Jacob Dougherty, AGACNP-BC is a medicare enrolled "Nurse Practitioner - Acute Care" in Centerville, Ohio. His current practice location is 2400 Miami Valley Dr, Centerville, Ohio. You can reach out to his office (for appointments etc.) via phone at (937) 438-2400.

Jacob Dougherty is licensed to practice in Ohio (license number APRN.CNP.0032076) 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 1821712316.

Contact Information

Jacob Dougherty, AGACNP-BC
2400 Miami Valley Dr,
Centerville, OH 45459-4774
(937) 438-2400
Not Available

Map and Direction




Provider's Profile

Full NameJacob Dougherty
GenderMale
SpecialityNurse Practitioner - Acute Care
Location2400 Miami Valley Dr, Centerville, Ohio
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1821712316
  • Provider Enumeration Date: 09/28/2022
  • Last Update Date: 12/17/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 2163894171
  • Enrollment ID: I20230220001749

Medical Identifiers

Medical identifiers for Jacob Dougherty such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1821712316NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2100XNurse Practitioner - Acute Care APRN.CNP.0032076 (Ohio)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 Dougherty allows following entities to bill medicare on his behalf.
Entity NamePremier Health Specialists Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1194958223
PECOS PAC ID: 5597708594
Enrollment ID: O20050610000010
Entity NameRajesh C Patel Md Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467446369
PECOS PAC ID: 2961538467
Enrollment ID: O20100408000316

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 Dougherty 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
Jacob Dougherty, AGACNP-BC
463 Columbus Ave Unit 23,
Lebanon, OH 45036-2688

Ph: () -		Jacob Dougherty, AGACNP-BC
2400 Miami Valley Dr,
Centerville, OH 45459-4774

Ph: (937) 438-2400

Reviews and Comments


Nurse Practitioner Nurses in Centerville, OH

Brittany Renee Montgomery, CNP
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Practice Location: 5400 Cornerstone North Blvd, Centerville, OH 45440
Phone: 937-528-7070    
Mr. Benjamin Daniel Malcolm, FNP
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Practice Location: 1095 S Main St, Centerville, OH 45458
Phone: 937-439-8622    
Heather Davis, NP
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Medicare: Medicare Enrolled
Practice Location: 2400 Miami Valley Dr, Centerville, OH 45459
Phone: 937-438-2400    
Eric Harris, FNP
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Medicare: Accepting Medicare Assignments
Practice Location: 6611 Clyo Rd, Centerville, OH 45459
Phone: 937-208-8282    
Terri M Caputo-jones, CRNP
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Medicare: Medicare Enrolled
Practice Location: 330 N Main St, Centerville, OH 45459
Phone: 937-435-1445    Fax: 937-439-7552
Alysha Weeter,
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Practice Location: 217 Amber Dr, Centerville, OH 45458
Phone: 937-510-4075    
Marie Middleton, NP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 7740 Washington Village Dr, Ste 120, Centerville, OH 45459
Phone: 937-439-7411    Fax: 937-433-8030

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.