Dr Jacob Joseph Chevlen, DO is a medicare enrolled "Emergency Medicine" physician in Mount Gilead, Ohio. His current practice location is
651 W Marion Rd, Mount Gilead, Ohio. You can reach out to his office (for appointments etc.) via phone at
(419) 949-3180.
Dr Jacob Joseph Chevlen is licensed to practice in Ohio (license number 34.015264) 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 1619504859.
Physician's Profile
| Full Name | Dr Jacob Joseph Chevlen |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Location | 651 W Marion Rd, Mount Gilead, Ohio |
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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: 1619504859
- Provider Enumeration Date: 03/26/2020
- Last Update Date: 06/27/2025
Medicare PECOS Information:
- PECOS PAC ID: 8527450907
- Enrollment ID: I20220114000736
Medical Identifiers
Medical identifiers for Dr Jacob Joseph Chevlen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619504859 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208D00000X | General Practice | 34.015264 (Ohio) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 207P00000X | Emergency Medicine | 34.015264 (Ohio) | 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 Jacob Joseph Chevlen allows following entities to bill medicare on his behalf.
| Entity Name | Signify Health Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1689158487
PECOS PAC ID: 3274895263
Enrollment ID: O20210303002044 |
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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 Jacob Joseph Chevlen 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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Dr Jacob Joseph Chevlen, DO
307 S Evergreen Ave,
Woodbury, NJ 08096-2739
Ph: () - | Dr Jacob Joseph Chevlen, DO
651 W Marion Rd,
Mount Gilead, OH 43338-1027
Ph: (419) 949-3180 |
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