Jacob Sup, DO - Medicare Family Practice in Caldwell, ID

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Jacob Sup, DO is a medicare enrolled "Family Medicine" physician in Caldwell, Idaho. He went to At Still Un Of Hlth Sciences, Col Of Osteo Med, Mesa and graduated in 2017 and has 7 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Community Health Clinics Inc and his current practice location is 2005 Arlington Ave, Caldwell, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 459-1025.

Jacob Sup is licensed to practice in Idaho (license number O-1402) 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 1295266401.

Contact Information

Jacob Sup, DO
2005 Arlington Ave,
Caldwell, ID 83605-4808
(208) 459-1025
(208) 459-1080

Map and Direction




Physician's Profile

Full NameJacob Sup
GenderMale
SpecialityFamily Practice
Experience7 Years
Location2005 Arlington Ave, Caldwell, Idaho
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jacob Sup attended and graduated from At Still Un Of Hlth Sciences, Col Of Osteo Med, Mesa in 2017
  NPI Data:
  • NPI Number: 1295266401
  • Provider Enumeration Date: 03/21/2017
  • Last Update Date: 08/07/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 0749609055
  • Enrollment ID: I20201005002920

Medical Identifiers

Medical identifiers for Jacob Sup such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1295266401NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine O-1402 (Idaho)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Saint Alphonsus Medical Center - NampaNampa, IDHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Community Health Clinics Inc408252735366

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 Sup allows following entities to bill medicare on his behalf.
Entity NameCommunity Health Clinics Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457309122
PECOS PAC ID: 4082527353
Enrollment ID: O20040130000055

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 Sup 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 AddressPractice Location Address
Jacob Sup, DO
Po Box 9,
Nampa, ID 83653-0009

Ph: (208) 467-4431		Jacob Sup, DO
2005 Arlington Ave,
Caldwell, ID 83605-4808

Ph: (208) 459-1025

Reviews and Comments


Family Medicine Doctors in Caldwell, ID

Stacy Jane Lamers, DO
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 315 E Elm St Ste 201, Caldwell, ID 83605
Phone: 208-514-2528    Fax: 208-375-2217
Miss J'cinda J'nae Bitters, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 211 E Logan St Ste 301, Caldwell, ID 83605
Phone: 208-459-4667    Fax: 208-459-3372
Lindsay Kaye Orme, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 315 E Elm St Ste 201, Caldwell, ID 83605
Phone: 208-514-2528    Fax: 208-375-2217
John R Pearce, DO
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 1825 S Kimball Ave, Caldwell, ID 83605
Phone: 208-455-3545    Fax: 208-454-9690
Roger Wyatt, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 315 E Elm St, Ste 100, Caldwell, ID 83605
Phone: 208-302-7100    Fax: 208-302-7155
Samantha Portenier, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 315 E Elm St Ste 201, Caldwell, ID 83605
Phone: 208-514-2528    Fax: 208-375-2217

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.