Dr Jack T Sproul, MD is a medicare enrolled "Orthopaedic Surgery" physician in Galax, Virginia. His current practice location is
101 Doctors Park, Galax, Virginia. You can reach out to his office (for appointments etc.) via phone at
(276) 238-0990.
Dr Jack T Sproul is licensed to practice in Virginia (license number 0101254866) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1588644116.
Physician's Profile
| Full Name | Dr Jack T Sproul |
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| Gender | Male |
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| Speciality | Orthopaedic Surgery |
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| Location | 101 Doctors Park, Galax, Virginia |
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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: 1588644116
- Provider Enumeration Date: 01/19/2006
- Last Update Date: 09/29/2015
Medicare PECOS Information:
- PECOS PAC ID: 6103809595
- Enrollment ID: I20190506001435
Medical Identifiers
Medical identifiers for Dr Jack T Sproul such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1588644116 | NPI | - | NPPES |
| 01243865 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207X00000X | Orthopaedic Surgery | 185796 (New York) | Secondary |
| 207X00000X | Orthopaedic Surgery | 0101254866 (Virginia) | 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. Dr Jack T Sproul allows following entities to bill medicare on his behalf.
| Entity Name | Hartsville Medical Group, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1598995300
PECOS PAC ID: 7012062714
Enrollment ID: O20090902000027 |
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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. Dr Jack T Sproul 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 |
|---|
Dr Jack T Sproul, MD
101 Doctors Park,
Galax, VA 24333-2277
Ph: (276) 238-0990 | Dr Jack T Sproul, MD
101 Doctors Park,
Galax, VA 24333-2277
Ph: (276) 238-0990 |
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