Jacob Ryan Stewart, MD is a medicare enrolled "Dermatology" physician in North Logan, Utah. He went to University Of Texas Southwestern Medical School At Dallas and graduated in 2018 and has 8 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Kelly W Hubbard Md Pc and his current practice location is
2245 N 400 E Ste 104, North Logan, Utah. You can reach out to his office (for appointments etc.) via phone at
(435) 752-5741.
Jacob Ryan Stewart is licensed to practice in Utah (license number 12745059-1205) 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 1962909937.
Physician's Profile
| Full Name | Jacob Ryan Stewart |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 8 Years |
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| Location | 2245 N 400 E Ste 104, North Logan, Utah |
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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:
- Jacob Ryan Stewart attended and graduated from University Of Texas Southwestern Medical School At Dallas in 2018
NPI Data:
- NPI Number: 1962909937
- Provider Enumeration Date: 04/06/2018
- Last Update Date: 08/05/2025
Medicare PECOS Information:
- PECOS PAC ID: 1658628755
- Enrollment ID: I20230614001242
Medical Identifiers
Medical identifiers for Jacob Ryan Stewart such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1962909937 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | 12745059-1205 (Utah) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Kelly W Hubbard Md Pc | 1951499433 | 5 |
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 Ryan Stewart allows following entities to bill medicare on his behalf.
| Entity Name | Kelly W Hubbard Md Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770779985
PECOS PAC ID: 1951499433
Enrollment ID: O20071130000165 |
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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 Ryan Stewart 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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Jacob Ryan Stewart, MD
2245 N 400 E Ste 104,
North Logan, UT 84341-1785
Ph: (608) 785-0940 | Jacob Ryan Stewart, MD
2245 N 400 E Ste 104,
North Logan, UT 84341-1785
Ph: (435) 752-5741 |
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