Jacob Michael Kisiel, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Lebanon, New Hampshire. His current practice location is
1 Medical Center Dr, Lebanon, New Hampshire. You can reach out to his office (for appointments etc.) via phone at
(603) 650-5000.
Jacob Michael Kisiel is licensed to practice in New Hampshire (license number R4575) 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 1952049520.
Physician's Profile
Full Name | Jacob Michael Kisiel |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 1 Medical Center Dr, Lebanon, New Hampshire |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1952049520
- Provider Enumeration Date: 05/24/2022
- Last Update Date: 07/04/2025
Medicare PECOS Information:
- PECOS PAC ID: 7911387279
- Enrollment ID: I20220704000130
Medical Identifiers
Medical identifiers for Jacob Michael Kisiel such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1952049520 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2084P0800X | Psychiatry & Neurology - Psychiatry | OT021611 (Pennsylvania) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | R4575 (New Hampshire) | Primary |
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. Jacob Michael Kisiel 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 |
Jacob Michael Kisiel, DO 1 Medical Center Dr, Lebanon, NH 03756-0001 Ph: (603) 650-5000 | Jacob Michael Kisiel, DO 1 Medical Center Dr, Lebanon, NH 03756-1000 Ph: (603) 650-5000 |
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