| Mary Amanda Jacobs, MD | |
|
2188 Sandy Dr, State College, PA 16803-2288 | |
| (814) 237-6600 | |
| (814) 237-5383 |
| Full Name | Mary Amanda Jacobs |
|---|---|
| Gender | Female |
| Speciality | Micrographic Dermatologic Surgery (mds) |
| Experience | 23 Years |
| Location | 2188 Sandy Dr, State College, Pennsylvania |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811973894 | NPI | - | NPPES |
| 35163500 | Medicaid | WI | |
| ENROLLED | Medicaid | IA | |
| 699485700 | Medicaid | MN | |
| 102337081 | Medicaid | PA | |
| P00333407 | Other | MN | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 46763 (Minnesota) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | MD437386 (Pennsylvania) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Penn Highlands Dubois | Dubois, PA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mount Nittany Medical Center Health Services Inc | 8426136797 | 366 |
| Dubois Dermatology And Cosmetics Llc | 8022324003 | 4 |
| Entity Name | Geisinger Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366493868 PECOS PAC ID: 5395657001 Enrollment ID: O20040130000518 |
| Entity Name | Dubois Dermatology and Cosmetics LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225419666 PECOS PAC ID: 8022324003 Enrollment ID: O20150908000183 |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Amanda Jacobs, MD 155 Wellness Way, State College, PA 16803-6702 Ph: (814) 231-7100 | Mary Amanda Jacobs, MD 2188 Sandy Dr, State College, PA 16803-2288 Ph: (814) 237-6600 |
Erinolaoluwa Funmibi Araoye, Dermatology Medicare: Accepting Medicare Assignments Practice Location: 200 Scenery Dr, State College, PA 16801 Phone: 814-231-4560 Fax: 814-231-6246 |
Timothy David Mckinley, Dermatology Medicare: Accepting Medicare Assignments Practice Location: 200 Scenery Dr, State College, PA 16801 Phone: 814-231-4560 Fax: 814-231-6246 |
Dr. Maria Isabel Longo-imedio, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 303 Benner Pike, State College, PA 16801 Phone: 814-272-5660 Fax: 814-272-5675 |
Dr. Cassandra Joy Simonetta, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 32 Colonnade Way, State College, PA 16803 Phone: 814-272-4445 Fax: 814-272-4450 |
Jerry Forrest Mikesell, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1393 N Atherton St, State College, PA 16803 Phone: 814-238-6097 Fax: 814-238-5527 |
Dr. Loretta A Pratt, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1850 E Park Ave, Suite 312, State College, PA 16803 Phone: 814-237-6600 Fax: 814-237-5383 |
Lorraine Rosamilia, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2188 Sandy Dr, State College, PA 16803 Phone: 814-237-6600 Fax: 814-237-5383 |