Lisa Susan Jacob, DDS in Kyle, TX - Medicare Dentist Provider

Lisa Susan Jacob, DDS is a medicare enrolled "Dentist - Pediatric Dentistry" provider in Kyle, Texas. Her current practice location is 2810 Dacy Ln, Kyle, Texas. You can reach out to her office (for appointments etc.) via phone at (210) 233-7000.

Lisa Susan Jacob is licensed to practice in Texas (license number 19077) 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 1386688331.

Contact Information

	Lisa Susan Jacob, DDS
	2810 Dacy Ln, Kyle, TX 78640-6322
	(210) 233-7000
	(512) 268-2253

Map and Direction

Healthcare Provider's Profile

Full Name	Lisa Susan Jacob
Gender	Female
Speciality	Dentist - Pediatric Dentistry
Location	2810 Dacy Ln, Kyle, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1386688331
Provider Enumeration Date: 06/16/2006
Last Update Date: 09/11/2025

Medicare PECOS Information:

PECOS PAC ID: 5193870152
Enrollment ID: I20090827000559

Medical Identifiers

Medical identifiers for Lisa Susan Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1386688331	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	19077 (Texas)	Secondary
1223S0112X	Dentist - Oral And Maxillofacial Surgery	19077 (Texas)	Secondary
1223P0221X	Dentist - Pediatric Dentistry	19077 (Texas)	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. Lisa Susan Jacob allows following entities to bill medicare on her behalf.

Entity Name	Dell Childrens Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326072943 PECOS PAC ID: 8224092978 Enrollment ID: O20041112001030

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. Lisa Susan Jacob 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
Lisa Susan Jacob, DDS 1301 Barbara Jordan Blvd Ste 301, Austin, TX 78723-3078 Ph: (512) 324-9999	Lisa Susan Jacob, DDS 2810 Dacy Ln, Kyle, TX 78640-6322 Ph: (210) 233-7000

Reviews and Comments

Dentist in Kyle, TX

Dr. Reann Boss, DDS, MHA Dentist Medicare: Not Enrolled in Medicare Practice Location: 844 Kohlers Xing Ste 220, Kyle, TX 78640 Phone: 512-549-4405
Dr. David Holden Chase Rivera, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 5581 Kyle Center Dr Ste 104, Kyle, TX 78640 Phone: 512-262-9191
Dr. Kyle Nathan Walker, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 809 W Center St, Kyle, TX 78640 Phone: 512-268-4200 Fax: 512-268-4242
Christopher R Hastings, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 2810 Dacy Ln, Kyle, TX 78640 Phone: 512-268-8900 Fax: 512-268-2250
Anusha Kotha, DDS Dentist Medicare: Medicare Enrolled Practice Location: 2810 Dacy Ln, Kyle, TX 78640 Phone: 210-233-7000 Fax: 210-625-5689
Dr. Alexis Yvonne Tessler, D.D.S., M.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 5401 Fm 1626, Suite 820, Kyle, TX 78640 Phone: 512-262-7895
Shreya Nair, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 5103 Kyle Center Dr Ste 105, Kyle, TX 78640 Phone: 512-268-2375

Lisa Susan Jacob, DDS - Medicare Dentist in Kyle, TX