Jacob A Russell, is a medicare enrolled "Occupational Therapist" provider in Belle Fourche, South Dakota. His current practice location is
2200 13th Ave, Belle Fourche, South Dakota. You can reach out to his office (for appointments etc.) via phone at
(605) 892-3331.
Jacob A Russell is licensed to practice in * (Not Available) (license number ) 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 1881300861.
Healthcare Provider's Profile
| Full Name | Jacob A Russell |
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| Gender | Male |
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| Speciality | Occupational Therapist |
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| Location | 2200 13th Ave, Belle Fourche, South Dakota |
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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: 1881300861
- Provider Enumeration Date: 01/24/2023
- Last Update Date: 01/24/2023
Medicare PECOS Information:
- PECOS PAC ID: 1456797950
- Enrollment ID: I20240306003639
Medical Identifiers
Medical identifiers for Jacob A Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1881300861 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | (* (Not Available)) | 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 A Russell allows following entities to bill medicare on his behalf.
| Provider Name | Paragon Outpatient Rehabilitation Services, Llc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1871867325
PECOS PAC ID: 8022272848
Enrollment ID: O20160728001716 |
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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 A Russell 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 A Russell,
4713 Glanstonbury Dr,
Hilliard, OH 43026-8654
Ph: (614) 592-4670 | Jacob A Russell,
2200 13th Ave,
Belle Fourche, SD 57717-2215
Ph: (605) 892-3331 |
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