Jaclyn Riley, in Canton, MI - Medicare Nurse Practitioner

Jaclyn Riley, is a medicare enrolled "Nurse Practitioner" in Canton, Michigan. Her current practice location is 2050 N Haggerty Rd Ste 200, Canton, Michigan. You can reach out to her office (for appointments etc.) via phone at (313) 550-3353.

Jaclyn Riley is licensed to practice in Michigan (license number 4704347010) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063000545.

Contact Information

	Jaclyn Riley,
	2050 N Haggerty Rd Ste 200, Canton, MI 48187-3796
	(313) 550-3353
	Not Available

Map and Direction

Provider's Profile

Full Name	Jaclyn Riley
Gender	Female
Speciality	Nurse Practitioner
Location	2050 N Haggerty Rd Ste 200, Canton, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063000545
Provider Enumeration Date: 01/09/2021
Last Update Date: 09/29/2023

Medicare PECOS Information:

PECOS PAC ID: 1850706854
Enrollment ID: I20210225002315

Medical Identifiers

Medical identifiers for Jaclyn Riley such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063000545	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	4704347010 (Michigan)	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. Jaclyn Riley allows following entities to bill medicare on her behalf.

Entity Name	Beaumont Medical Group- Specialty Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1578072906 PECOS PAC ID: 7214299866 Enrollment ID: O20180320002549

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. Jaclyn Riley 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
Jaclyn Riley, 1083 Beaconsfield Ave, Grosse Pointe Park, MI 48230-1346 Ph: (313) 550-3353	Jaclyn Riley, 2050 N Haggerty Rd Ste 200, Canton, MI 48187-3796 Ph: (313) 550-3353

Reviews and Comments

Nurse Practitioner Nurses in Canton, MI

Lucinda Pryor, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1161 Stacy Dr, Canton, MI 48188 Phone: 313-740-5358
Wendy Storey, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 49650 Cherry Hill Rd, Suite 210, Canton, MI 48187 Phone: 734-398-7899 Fax: 734-398-7895
Molly Mcintyre, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 49650 Cherry Hill Rd, Suite 210, Canton, MI 48187 Phone: 734-398-7899 Fax: 734-398-7895
Patricia Reckling, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 49650 Cherry Hill Rd, Suite 210, Canton, MI 48187 Phone: 734-398-7899 Fax: 734-398-7895
Mrs. Theodora Chukwudi, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 45300 Cherry Hill Rd, Canton, MI 48187 Phone: 734-981-3968
Jennifer Martz, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6300 N Haggerty Rd, Suite Number 210, Canton, MI 48187 Phone: 734-641-3000

Jaclyn Riley, - Medicare Nurse Practitioner in Canton, MI