Jaclyn Evans, OTR/L in Decatur, IL - Medicare Occupational Therapist Provider

Jaclyn Evans, OTR/L is a medicare enrolled "Occupational Therapist" provider in Decatur, Illinois. Her current practice location is 875 W Mckinley Ave, Decatur, Illinois. You can reach out to her office (for appointments etc.) via phone at (217) 872-1282.

Jaclyn Evans is licensed to practice in Illinois (license number 056015359) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1457840621.

Contact Information

	Jaclyn Evans, OTR/L
	875 W Mckinley Ave, Decatur, IL 62526-3287
	(217) 872-1282
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jaclyn Evans
Gender	Female
Speciality	Occupational Therapist
Location	875 W Mckinley Ave, Decatur, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1457840621
Provider Enumeration Date: 05/03/2018
Last Update Date: 06/20/2023

Medicare PECOS Information:

PECOS PAC ID: 3779814207
Enrollment ID: I20230406000581

Medical Identifiers

Medical identifiers for Jaclyn Evans such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457840621	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	4925 (Tennessee)	Secondary
225X00000X	Occupational Therapist	056015359 (Illinois)	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. Jaclyn Evans allows following entities to bill medicare on her behalf.

Provider Name	Comprehensive Therapeutics Ltd
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1699094102 PECOS PAC ID: 8921230137 Enrollment ID: O20140422000663

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. Jaclyn Evans 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
Jaclyn Evans, OTR/L 206 County Road 754, Riceville, TN 37370-5260 Ph: () -	Jaclyn Evans, OTR/L 875 W Mckinley Ave, Decatur, IL 62526-3287 Ph: (217) 872-1282

Reviews and Comments

Occupational Therapist in Decatur, IL

Carla A Tippitt, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1415 W Mound Rd, Decatur, IL 62526 Phone: 217-824-2991
Elissa Marie Mclane, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2300 N Edward St, Decatur, IL 62526 Phone: 217-876-2600
Jessica Alyse Grunden, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 875 W Mckinley Ave, Decatur, IL 62526 Phone: 217-872-1282
Mrs. Alicia Elaine Corman, MED., OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1800 E. Lake Shore Drive, Decatur, IL 62521 Phone: 217-464-2981
Nicole Stelly, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2300 N Edward St, Decatur, IL 62526 Phone: 217-876-2600
Justin Nelson, OTD, OTR/L, LAT, ATC Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1415 W Mound Rd, Decatur, IL 62526 Phone: 217-615-3741
Jody Ferracane, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2300 N Edward St, Decatur, IL 62526 Phone: 217-876-2600

Jaclyn Evans, OTR/L - Medicare Occupational Therapist in Decatur, IL