Jacob Kettner, PT in Fayetteville, AR - Medicare Physical Therapist Provider

Jacob Kettner, PT is a medicare enrolled "Physical Therapist - Pediatrics" provider in Fayetteville, Arkansas. His current practice location is 3399 Black Forest Dr Ste 3, Fayetteville, Arkansas. You can reach out to his office (for appointments etc.) via phone at (417) 300-9965.

Jacob Kettner 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 1225683808.

Contact Information

	Jacob Kettner, PT
	3399 Black Forest Dr Ste 3, Fayetteville, AR 72704-6541
	(417) 300-9965
	(417) 494-4173

Map and Direction

Healthcare Provider's Profile

Full Name	Jacob Kettner
Gender	Male
Speciality	Physical Therapist - Pediatrics
Location	3399 Black Forest Dr Ste 3, Fayetteville, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1225683808
Provider Enumeration Date: 08/09/2019
Last Update Date: 10/18/2023

Medicare PECOS Information:

PECOS PAC ID: 3779960273
Enrollment ID: I20220523002707

Medical Identifiers

Medical identifiers for Jacob Kettner such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225683808	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	PT4666 (Arkansas)	Secondary
2251P0200X	Physical Therapist - Pediatrics	(* (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 Kettner allows following entities to bill medicare on his behalf.

Provider Name	Advanced Physical Therapy Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1427401702 PECOS PAC ID: 5395032882 Enrollment ID: O20160927002419

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 Kettner 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
Jacob Kettner, PT 6815 Isaacs Orchard Rd Ste D, Springdale, AR 72762-6285 Ph: (479) 856-6400	Jacob Kettner, PT 3399 Black Forest Dr Ste 3, Fayetteville, AR 72704-6541 Ph: (417) 300-9965

Reviews and Comments

Physical Therapist in Fayetteville, AR

Karen Hairston, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2474 E Joyce Blvd, Suite 2, Fayetteville, AR 72703 Phone: 479-521-8326 Fax: 479-521-5439
Fernando Castillo, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3383 N Mana Ct Ste 201, Fayetteville, AR 72703 Phone: 479-571-6780
Kymbrly Hannah, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2474 E Joyce Blvd, Suite 2, Fayetteville, AR 72703 Phone: 479-521-8326 Fax: 479-521-5439
Ms. Heather Kristine Vaughn, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1125 N College Ave, Fayetteville, AR 72703 Phone: 479-713-8630 Fax: 479-713-8639
Megan Landry Wilson, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1923 E Joyce Blvd, Fayetteville, AR 72703 Phone: 479-442-7220
Travis Alexander, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 3399 Black Forest Dr Ste 3, Fayetteville, AR 72704 Phone: 479-435-6712 Fax: 844-317-0394
Winston Tyler Futrell, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2668 E Citizens Dr Ste 5, Fayetteville, AR 72703 Phone: 479-595-0711

Jacob Kettner, PT - Medicare Physical Therapist in Fayetteville, AR