Jacob Nelson, DO is a medicare enrolled "Pediatrics" physician in Dyess Afb, Texas. His current practice location is
697 Louisiana Rd, Dyess Afb, Texas. You can reach out to his office (for appointments etc.) via phone at
(325) 696-4677.
Jacob Nelson is licensed to practice in Idaho (license number O-1220) 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 1144675679.
Physician's Profile
Full Name | Jacob Nelson |
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Gender | Male |
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Speciality | Pediatrics |
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Location | 697 Louisiana Rd, Dyess Afb, Texas |
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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: 1144675679
- Provider Enumeration Date: 05/03/2016
- Last Update Date: 06/21/2019
Medicare PECOS Information:
- PECOS PAC ID: 0941725451
- Enrollment ID: I20250417000383
Medical Identifiers
Medical identifiers for Jacob Nelson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1144675679 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | BP10056551 (Texas) | Secondary |
208000000X | Pediatrics | O-1220 (Idaho) | 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. Jacob Nelson allows following entities to bill medicare on his behalf.
Entity Name | Chickasaw Nation Division Of Health |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1255364923 PECOS PAC ID: 8426957523 Enrollment ID: O20040108000364 |
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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. Jacob Nelson 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 Nelson, DO 697 Louisiana Rd, Dyess Afb, TX 79607-1141 Ph: (325) 696-4677 | Jacob Nelson, DO 697 Louisiana Rd, Dyess Afb, TX 79607-1141 Ph: (325) 696-4677 |
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