Dr Jaclyn J Bohm, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Rosemount, Minnesota. She went to Kent State University College Of Podiatric Medicine and graduated in 2008 and has 17 years of diverse experience with area of expertise as Podiatry. She is a member of the group practice Fairview Express Care and her current practice location is
15705 Cimarron Ave, Rosemount, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(651) 322-8800.
Dr Jaclyn J Bohm is licensed to practice in Minnesota (license number 842) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1306005111.
Healthcare Provider's Profile
| Full Name | Dr Jaclyn J Bohm |
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| Gender | Female |
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| Speciality | Podiatry |
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| Experience | 17 Years |
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| Location | 15705 Cimarron Ave, Rosemount, Minnesota |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Jaclyn J Bohm attended and graduated from Kent State University College Of Podiatric Medicine in 2008
NPI Data:
- NPI Number: 1306005111
- Provider Enumeration Date: 06/06/2008
- Last Update Date: 07/25/2012
Medicare PECOS Information:
- PECOS PAC ID: 2466620968
- Enrollment ID: I20110728000455
Medical Identifiers
Medical identifiers for Dr Jaclyn J Bohm such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1306005111 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 842 (Minnesota) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Fairview Express Care | 3375645179 | 1537 |
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. Dr Jaclyn J Bohm allows following entities to bill medicare on her behalf.
| Provider Name | Fairview Health Services |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1013994359
PECOS PAC ID: 1951213057
Enrollment ID: O20031105000461 |
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| Provider Name | Fairview Clinics |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1346432218
PECOS PAC ID: 7113830142
Enrollment ID: O20031106000516 |
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| Provider Name | Fairview Express Care |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1053952606
PECOS PAC ID: 3375645179
Enrollment ID: O20081028000548 |
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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. Dr Jaclyn J Bohm 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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Dr Jaclyn J Bohm, DPM
15075 Cimarron Ave,
Rosemount, MN 55068-1635
Ph: (651) 322-8800 | Dr Jaclyn J Bohm, DPM
15705 Cimarron Ave,
Rosemount, MN 55068
Ph: (651) 322-8800 |
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