Jacob Brushaber-drockton, in Salt Lake City, UT - Medicare Psychologist Provider

Jacob Brushaber-drockton, is a medicare enrolled "Psychologist" provider in Salt Lake City, Utah. His current practice location is 350 S 400 E, Salt Lake City, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 582-5534.

Jacob Brushaber-drockton 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 1235785452.

Contact Information

	Jacob Brushaber-drockton,
	350 S 400 E, Salt Lake City, UT 84111-2905
	(801) 582-5534
	(801) 582-5540

Map and Direction

Healthcare Provider's Profile

Full Name	Jacob Brushaber-drockton
Gender	Male
Speciality	Psychologist
Location	350 S 400 E, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1235785452
Provider Enumeration Date: 08/13/2019
Last Update Date: 08/13/2019

Medicare PECOS Information:

PECOS PAC ID: 9335568252
Enrollment ID: I20200926000131

Medical Identifiers

Medical identifiers for Jacob Brushaber-drockton such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1235785452	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	(* (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 Brushaber-drockton allows following entities to bill medicare on his behalf.

Entity Name	Partners In Change: Psychological & Community Services, Plc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1093984817 PECOS PAC ID: 7719050814 Enrollment ID: O20080723000347

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 Brushaber-drockton 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 Brushaber-drockton, 350 S 400 E, Salt Lake City, UT 84111-2905 Ph: (801) 582-5534	Jacob Brushaber-drockton, 350 S 400 E, Salt Lake City, UT 84111-2905 Ph: (801) 582-5534

Reviews and Comments

Psychologist in Salt Lake City, UT

Dr. Rachel Leigh Hopkins, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 164 S 900 E, Salt Lake City, UT 84102 Phone: 801-419-0139 Fax: 385-227-8099
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Bruce Dennis Etringer, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 675 E 2100 S Ste 250, Salt Lake City, UT 84106 Phone: 801-467-8890 Fax: 801-484-3862
Dr. Ann H Tyler, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4505 So Wasatch Blvd, Suite #380, Salt Lake City, UT 84124 Phone: 801-273-7835

Jacob Brushaber-drockton, - Medicare Psychologist in Salt Lake City, UT