Dr Jack Victor Carlisle, MD in Grand Rapids, MN

Dr Jack Victor Carlisle, MD is a medicare enrolled "Family Medicine" physician in Grand Rapids, Minnesota. He went to Rush Medical College Of Rush University and graduated in 1987 and has 37 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Grand Itasca Clinic And Hospital and his current practice location is 1601 Golf Course Rd, Grand Rapids, Minnesota. You can reach out to his office (for appointments etc.) via phone at (218) 326-5000.

Dr Jack Victor Carlisle is licensed to practice in Minnesota (license number 31750) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1326023060.

Contact Information

	Dr Jack Victor Carlisle, MD
	1601 Golf Course Rd, Grand Rapids, MN 55744-8648
	(218) 326-5000
	(218) 326-1461

Map and Direction

Physician's Profile

Full Name	Dr Jack Victor Carlisle
Gender	Male
Speciality	Family Practice
Experience	37 Years
Location	1601 Golf Course Rd, Grand Rapids, Minnesota
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Jack Victor Carlisle attended and graduated from Rush Medical College Of Rush University in 1987

NPI Data:

NPI Number: 1326023060
Provider Enumeration Date: 12/14/2005
Last Update Date: 02/12/2013

Medicare PECOS Information:

PECOS PAC ID: 0244142412
Enrollment ID: I20080304000641

Medical Identifiers

Medical identifiers for Dr Jack Victor Carlisle such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1326023060	NPI	-	NPPES
462700800	Medicaid	MN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	31750 (Minnesota)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Recover Health	Grand rapids, MN	Home health agency
Grand Itasca Clinic & Hosp Homecare	Grand rapids, MN	Home health agency
Grand Itasca Clinic And Hospital	Grand rapids, MN	Hospital
St Lukes Hospital	Duluth, MN	Hospital
The Emeralds At Grand Rapids Llc	Grand rapids, MN	Nursing home

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Grand Itasca Clinic And Hospital	8123939550	115

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 Victor Carlisle allows following entities to bill medicare on his behalf.

Entity Name	Grand Itasca Clinic And Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669426631 PECOS PAC ID: 8123939550 Enrollment ID: O20031105000209

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 Victor Carlisle 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 Victor Carlisle, MD 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 Ph: (218) 326-5000	Dr Jack Victor Carlisle, MD 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 Ph: (218) 326-5000

Reviews and Comments

Family Medicine Doctors in Grand Rapids, MN

Dr. Patricia C. Carlin-janssen, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1601 Golf Course Rd, Grand Rapids, MN 55744 Phone: 218-326-5000
Anne Eileen Tofte, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1601 Golf Course Rd, Grand Rapids, MN 55744 Phone: 218-326-5000
Dr. Edwin A. Anderson, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1601 Golf Course Rd, Grand Rapids, MN 55744 Phone: 218-326-5000
Kristin A Johnson, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 409 Se 13th St, Grand Rapids, MN 55744 Phone: 218-326-9100 Fax: 218-326-9200
Dr. Timothy J. Pehl, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1601 Golf Course Rd, Grand Rapids, MN 55744 Phone: 218-326-5000
Dr. Michael B. Liebe, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1601 Golf Course Rd, Grand Rapids, MN 55744 Phone: 218-326-5000
Arie Degrio, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1601 Golf Course Rd, Grand Rapids, MN 55744 Phone: 218-999-1442 Fax: 218-999-1461

Dr Jack Victor Carlisle, MD - Medicare Family Practice in Grand Rapids, MN