Jasmine Monique Mack, DDS is a medicare enrolled "Dentist - General Practice" provider in Byhalia, Mississippi. Her current practice location is
34 Brunswick St, Byhalia, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(662) 838-6898.
Jasmine Monique Mack is licensed to practice in Mississippi (license number 4361-23) 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 1932859105.
Healthcare Provider's Profile
| Full Name | Jasmine Monique Mack |
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| Gender | Female |
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| Speciality | Dentist - General Practice |
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| Location | 34 Brunswick St, Byhalia, Mississippi |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1932859105
- Provider Enumeration Date: 03/28/2022
- Last Update Date: 06/13/2023
Medicare PECOS Information:
- PECOS PAC ID: 5597126672
- Enrollment ID: I20230804003636
Medical Identifiers
Medical identifiers for Jasmine Monique Mack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1932859105 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1223G0001X | Dentist - General Practice | 4361-23 (Mississippi) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (NU) | Secondary |
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. Jasmine Monique Mack allows following entities to bill medicare on her behalf.
| Entity Name | Northeast Mississippi Health Care Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1558410738
PECOS PAC ID: 5294717377
Enrollment ID: O20040602001469 |
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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. Jasmine Monique Mack 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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Jasmine Monique Mack, DDS
10886 County Road 44,
Linden, AL 36748-4137
Ph: Not Available | Jasmine Monique Mack, DDS
34 Brunswick St,
Byhalia, MS 38611-7000
Ph: (662) 838-6898 |
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