Jack Victor Lundbohm, is a medicare enrolled "Chiropractor" provider in Roseau, Minnesota. He went to Northwestern College Of Chiropractic and graduated in 1981 and has 43 years of diverse experience with area of expertise as Chiropractic. His current practice location is
317 2nd St Nw Ste A, Roseau, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(218) 463-2992.
Jack Victor Lundbohm is licensed to practice in Minnesota (license number 1792) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1275632234.
Healthcare Provider's Profile
| Full Name | Jack Victor Lundbohm |
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| Gender | Male |
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| Speciality | Chiropractic |
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| Experience | 43 Years |
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| Location | 317 2nd St Nw Ste A, Roseau, Minnesota |
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| Accepts Medicare Assignments | Yes. He 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:
- Jack Victor Lundbohm attended and graduated from Northwestern College Of Chiropractic in 1981
NPI Data:
- NPI Number: 1275632234
- Provider Enumeration Date: 09/22/2006
- Last Update Date: 09/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 0749217974
- Enrollment ID: I20050720000153
Medical Identifiers
Medical identifiers for Jack Victor Lundbohm such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1275632234 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | 1792 (Minnesota) | 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. Jack Victor Lundbohm allows following entities to bill medicare on his behalf.
| Provider Name | Jack V, Lundbohm Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1780822486
PECOS PAC ID: 7113077504
Enrollment ID: O20090605000084 |
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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. Jack Victor Lundbohm 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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Jack Victor Lundbohm,
317 2nd St Nw Ste A,
Roseau, MN 56751
Ph: (218) 463-2992 | Jack Victor Lundbohm,
317 2nd St Nw Ste A,
Roseau, MN 56751
Ph: (218) 463-2992 |
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