Tina Jacques, RN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Montgomery, Massachusetts. Her current practice location is
132 Carrington Rd, Montgomery, Massachusetts. You can reach out to her office (for appointments etc.) via phone at
(413) 374-2592.
Tina Jacques is licensed to practice in Massachusetts (license number RN200077) 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 1548821234.
Provider's Profile
Full Name | Tina Jacques |
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Gender | Female |
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Speciality | Nurse Practitioner - Psychiatric/mental Health |
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Location | 132 Carrington Rd, Montgomery, Massachusetts |
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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: 1548821234
- Provider Enumeration Date: 06/24/2019
- Last Update Date: 07/21/2020
Medicare PECOS Information:
- PECOS PAC ID: 0648680215
- Enrollment ID: I20201110002601
Medical Identifiers
Medical identifiers for Tina Jacques such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1548821234 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | RN200077 (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. Tina Jacques allows following entities to bill medicare on her behalf.
Entity Name | Mercy Inpatient Medical Associates Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1407845282 PECOS PAC ID: 7416846977 Enrollment ID: O20040312000517 |
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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. Tina Jacques 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 |
Tina Jacques, RN 132 Carrington Rd, Montgomery, MA 01050-9789 Ph: (413) 862-4030 | Tina Jacques, RN 132 Carrington Rd, Montgomery, MA 01050-9789 Ph: (413) 374-2592 |
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