Mrs Jibi Jacob, CNP is a medicare enrolled "Nurse Practitioner - Family" in Stone Park, Illinois. Her current practice location is
3520 W North Ave, Stone Park, Illinois. You can reach out to her office (for appointments etc.) via phone at
(708) 356-6341.
Mrs Jibi Jacob is licensed to practice in Illinois (license number 209024796) 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 1851046247.
Provider's Profile
Full Name | Mrs Jibi Jacob |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 3520 W North Ave, Stone Park, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1851046247
- Provider Enumeration Date: 02/15/2022
- Last Update Date: 02/15/2022
Medicare PECOS Information:
- PECOS PAC ID: 5890150528
- Enrollment ID: I20230502000186
Medical Identifiers
Medical identifiers for Mrs Jibi Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1851046247 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 209024796 (Illinois) | 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. Mrs Jibi Jacob allows following entities to bill medicare on her behalf.
Entity Name | Precision Immediate Care And Medical Center Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1689299257 PECOS PAC ID: 5991120198 Enrollment ID: O20200805001647 |
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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. Mrs Jibi 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 |
Mrs Jibi Jacob, CNP 8112 Cedar Dr, Woodridge, IL 60517-4646 Ph: () - | Mrs Jibi Jacob, CNP 3520 W North Ave, Stone Park, IL 60165-1042 Ph: (708) 356-6341 |
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