Mr Nyles Antony Jackson, MSW, APSW, SAC-IT is a medicare enrolled "Social Worker" provider in Kenosha, Wisconsin. He graduated from healthcare school in 2009 and has 15 years of diverse experience with area of expertise as Clinical Social Worker. He is a member of the group practice Oakwood Clinical Associates, Ltd and his current practice location is
4109 67th St, Kenosha, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(262) 652-9830.
Mr Nyles Antony Jackson is licensed to practice in Wisconsin (license number 128033-121) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1053637629.
Healthcare Provider's Profile
| Full Name | Mr Nyles Antony Jackson |
|---|
| Gender | Male |
|---|
| Speciality | Clinical Social Worker |
|---|
| Experience | 15 Years |
|---|
| Location | 4109 67th St, Kenosha, Wisconsin |
|---|
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Mr Nyles Antony Jackson graduated from medical school in 2009
NPI Data:
- NPI Number: 1053637629
- Provider Enumeration Date: 04/07/2010
- Last Update Date: 04/07/2010
Medicare PECOS Information:
- PECOS PAC ID: 7810204708
- Enrollment ID: I20150909001658
Medical Identifiers
Medical identifiers for Mr Nyles Antony Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053637629 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 15877-130 (Wisconsin) | Secondary |
| 104100000X | Social Worker | 128033-121 (Wisconsin) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Oakwood Clinical Associates, Ltd | 8022084383 | 3 |
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. Mr Nyles Antony Jackson allows following entities to bill medicare on his behalf.
| Entity Name | Oakwood Clinical Associates, Ltd |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1447289434
PECOS PAC ID: 8022084383
Enrollment ID: O20040908000656 |
|---|
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. Mr Nyles Antony Jackson 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 |
|---|
Mr Nyles Antony Jackson, MSW, APSW, SAC-IT
4109 67th St,
Kenosha, WI 53142-3836
Ph: (262) 652-9830 | Mr Nyles Antony Jackson, MSW, APSW, SAC-IT
4109 67th St,
Kenosha, WI 53142-3836
Ph: (262) 652-9830 |
Reviews and Comments