Dr Jeremy G Fisk, MD is a medicare enrolled "Family Medicine" physician in Cicero, Indiana. He went to Indiana University School Of Medicine and graduated in 2008 and has 17 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Riverview Hospital and his current practice location is
1160 S Peru St, Cicero, Indiana. You can reach out to his office (for appointments etc.) via phone at
(317) 984-9311.
Dr Jeremy G Fisk is licensed to practice in Indiana (license number 01066942A) 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 1174788780.
Physician's Profile
| Full Name | Dr Jeremy G Fisk |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 17 Years |
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| Location | 1160 S Peru St, Cicero, Indiana |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Jeremy G Fisk attended and graduated from Indiana University School Of Medicine in 2008
NPI Data:
- NPI Number: 1174788780
- Provider Enumeration Date: 07/23/2008
- Last Update Date: 04/17/2025
Medicare PECOS Information:
- PECOS PAC ID: 0840326609
- Enrollment ID: I20100331000415
Medical Identifiers
Medical identifiers for Dr Jeremy G Fisk such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174788780 | NPI | - | NPPES |
| 200977870 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 01066942A (Indiana) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Riverview Hospital | 1153216627 | 184 |
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 Jeremy G Fisk allows following entities to bill medicare on his behalf.
| Entity Name | Riverview Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1609074921
PECOS PAC ID: 1153216627
Enrollment ID: O20040216000572 |
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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 Jeremy G Fisk 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 Jeremy G Fisk, MD
Po Box 843022,
Kansas City, MO 64184-3022
Ph: (317) 770-6900 | Dr Jeremy G Fisk, MD
1160 S Peru St,
Cicero, IN 46034-9601
Ph: (317) 984-9311 |
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