Kurt Jaenicke, MD is a medicare enrolled "Obstetrics & Gynecology - Female Pelvic Medicine And Reconstructive Surgery" physician in Louisa, Kentucky. His current practice location is
412 N Lock Ave, Louisa, Kentucky. You can reach out to his office (for appointments etc.) via phone at
(606) 638-4595.
Kurt Jaenicke is licensed to practice in West Virginia (license number 16950) 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 1073671673.
Physician's Profile
| Full Name | Kurt Jaenicke |
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| Gender | Male |
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| Speciality | Obstetrics & Gynecology - Female Pelvic Medicine And Reconstructive Surgery |
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| Location | 412 N Lock Ave, Louisa, Kentucky |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1073671673
- Provider Enumeration Date: 12/05/2006
- Last Update Date: 04/26/2022
Medicare PECOS Information:
- PECOS PAC ID: 2264526276
- Enrollment ID: I20240603003994
Medical Identifiers
Medical identifiers for Kurt Jaenicke such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073671673 | NPI | - | NPPES |
| 0163719 | Medicaid | OH | |
| 000000583794 | Other | KY | ANTHEM BCBS |
| 64313091 | Medicaid | KY | |
| 000000510048 | Other | KY | ANTHEM BCBS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207VF0040X | Obstetrics & Gynecology - Female Pelvic Medicine And Reconstructive Surgery | 31309 (Kentucky) | Secondary |
| 207V00000X | Obstetrics & Gynecology | 31309 (Kentucky) | Secondary |
| 207V00000X | Obstetrics & Gynecology | 16950 (West Virginia) | Secondary |
| 207VF0040X | Obstetrics & Gynecology - Female Pelvic Medicine And Reconstructive Surgery | 16950 (West Virginia) | 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. Kurt Jaenicke allows following entities to bill medicare on his behalf.
| Entity Name | Lawton Indian Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760489223
PECOS PAC ID: 6406800234
Enrollment ID: O20050304000301 |
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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. Kurt Jaenicke 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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Kurt Jaenicke, MD
Po Box 5009,
Brentwood, TN 37024-5009
Ph: (615) 221-1400 | Kurt Jaenicke, MD
412 N Lock Ave,
Louisa, KY 41230-1115
Ph: (606) 638-4595 |
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