| Jacob Bottelberghe, | |
|
300 S Bruce St, Marshall, MN 56258-1934 | |
| (507) 537-9165 | |
| Not Available |
| Full Name | Jacob Bottelberghe |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 7 Years |
| Location | 300 S Bruce St, Marshall, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346894748 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Avera Marshall Regional Medical Center | Marshall, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Avera Marshall | 5799695227 | 102 |
| Entity Name | Avera Marshall |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568401016 PECOS PAC ID: 5799695227 Enrollment ID: O20031106000219 |
| Entity Name | Avera Marshall |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1568401016 PECOS PAC ID: 5799695227 Enrollment ID: O20091209000435 |
| Entity Name | Avera Tyler |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801840517 PECOS PAC ID: 9638088537 Enrollment ID: O20170630001868 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Bottelberghe, 1107 300th St, Minneota, MN 56264-1103 Ph: Not Available | Jacob Bottelberghe, 300 S Bruce St, Marshall, MN 56258-1934 Ph: (507) 537-9165 |
Miss Kate Marie Hegna, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 300 S Bruce St, Marshall, MN 56258 Phone: 507-532-9661 |
Taylor Renee Kor, Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 300 S Bruce St, Marshall, MN 56258 Phone: 507-532-9661 |
Bailey Varpness, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1521 Carlson St, Marshall, MN 56258 Phone: 507-476-4800 |
Mr. Derek K Groeneweg, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 300 S Bruce St, Marshall, MN 56258 Phone: 507-537-9007 Fax: 507-537-2734 |
Kristin M Wegner, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1420 East College Drive, Marshall, MN 56258 Phone: 507-532-9631 Fax: 507-532-1176 |
Emma B Bengtson, PHYSICIAN ASSISTANT Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1521 Carlson St, Marshall, MN 56258 Phone: 507-476-4800 |
Craig R Maki, PAC Physician Assistant Medicare: Medicare Enrolled Practice Location: 1420 E College Dr, Marshall, MN 56258 Phone: 507-532-9631 Fax: 507-532-1176 |