Samuel Porter Jacks, MD in Winston Salem, NC

Samuel Porter Jacks, MD is a medicare enrolled "Thoracic Surgery (cardiothoracic Vascular Surgery)" physician in Winston Salem, North Carolina. He went to Wake Forest University School Of Medicine and graduated in 2004 and has 20 years of diverse experience with area of expertise as Thoracic Surgery. He is a member of the group practice Novant Medical Group Inc and his current practice location is 4622 Country Club Rd, Suite 180, Winston Salem, North Carolina. You can reach out to his office (for appointments etc.) via phone at (336) 768-9535.

Samuel Porter Jacks is licensed to practice in North Carolina (license number 2015-01953) 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 1184828030.

Contact Information

	Samuel Porter Jacks, MD
	4622 Country Club Rd, Suite 180, Winston Salem, NC 27104-3769
	(336) 768-9535
	(336) 768-4155

Map and Direction

Physician's Profile

Full Name	Samuel Porter Jacks
Gender	Male
Speciality	Thoracic Surgery
Experience	20 Years
Location	4622 Country Club Rd, Winston Salem, North Carolina
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Samuel Porter Jacks attended and graduated from Wake Forest University School Of Medicine in 2004

NPI Data:

NPI Number: 1184828030
Provider Enumeration Date: 06/13/2007
Last Update Date: 10/25/2020

Medicare PECOS Information:

PECOS PAC ID: 8820245988
Enrollment ID: I20151118002677

Medical Identifiers

Medical identifiers for Samuel Porter Jacks such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184828030	NPI	-	NPPES
005979900	Medicaid	FL
003125978A	Medicaid	GA
P01084809	Other	FL	RAILROAD MEDICARE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	2015-01953 (North Carolina)	Secondary
208G00000X	Thoracic Surgery (cardiothoracic Vascular Surgery)	2015-01953 (North Carolina)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Novant Health Forsyth Medical Center	Winston-salem, NC	Hospital
Twin County Regional Hospital	Galax, VA	Hospital
Wilkes Regional Medical Center	North wilkesboro, NC	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Novant Medical Group Inc	1153234893	1996

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. Samuel Porter Jacks allows following entities to bill medicare on his behalf.

Entity Name	Novant Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366409492 PECOS PAC ID: 1153234893 Enrollment ID: O20031121000692

Entity Name	Novant Health Thomasville Medical Center Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033160205 PECOS PAC ID: 5890605224 Enrollment ID: O20031222000916

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. Samuel Porter Jacks 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
Samuel Porter Jacks, MD Po Box 60447, Charlotte, NC 28260-0447 Ph: (336) 768-9535	Samuel Porter Jacks, MD 4622 Country Club Rd, Suite 180, Winston Salem, NC 27104-3769 Ph: (336) 768-9535

Reviews and Comments

Thoracic Surgery (Cardiothoracic Vascular Surgery) Doctors in Winston Salem, NC

Dr. Joel Clarence Morgan, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Not Enrolled in Medicare Practice Location: 4622 Country Club Rd, Suite 180, Winston Salem, NC 27104 Phone: 336-768-9535 Fax: 336-768-4155
Dr. Adrian L Lata, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-4081 Fax: 336-716-3065
Edward Hal Kincaid, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-2255 Fax: 336-716-3348
Dr. Leonard James Wudel, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-4359
Dr. Peter John Smit, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: Department Of Cardiothoracic Surgery, Wake Forest Baptist Hospital Medical Center Boulevard, Winston Salem, NC 27157 Phone: 336-716-5222
Dr. Hadley Kitchin Wilson, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 4622 Country Club Rd Ste 180, Winston Salem, NC 27104 Phone: 336-768-9535 Fax: 336-768-4155
Dr. Bruce Douglas Walley, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Not Enrolled in Medicare Practice Location: 4622 Country Club Rd, Suite 180, Winston Salem, NC 27104 Phone: 336-768-9535 Fax: 336-768-4155

Samuel Porter Jacks, MD - Medicare Thoracic Surgery in Winston Salem, NC