Jacob Stout, in South Salt Lake, UT - Medicare Physician Assistant

Jacob Stout, is a medicare enrolled "Physician Assistant" in South Salt Lake, Utah. His current practice location is 2472 S 300 E, South Salt Lake, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 783-5011.

Jacob Stout is licensed to practice in Utah (license number 13593511-1206) 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 1952037939.

Contact Information

	Jacob Stout,
	2472 S 300 E, South Salt Lake, UT 84115-2895
	(801) 783-5011
	Not Available

Map and Direction

Provider's Profile

Full Name	Jacob Stout
Gender	Male
Speciality	Physician Assistant
Location	2472 S 300 E, South Salt Lake, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1952037939
Provider Enumeration Date: 08/01/2022
Last Update Date: 11/01/2023

Medicare PECOS Information:

PECOS PAC ID: 4183071053
Enrollment ID: I20231114003517

Medical Identifiers

Medical identifiers for Jacob Stout such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1952037939	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	13593511-1206 (Utah)	Primary

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. Jacob Stout 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
Jacob Stout, 1118 Moyle Dr, Alpine, UT 84004-1200 Ph: () -	Jacob Stout, 2472 S 300 E, South Salt Lake, UT 84115-2895 Ph: (801) 783-5011

Reviews and Comments

Physician Assistant Nurses in South Salt Lake, UT

Jennifer Makuakane, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 3355 S State St Ste B, South Salt Lake, UT 84115 Phone: 801-396-2075
Anna I Mair, C-PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 3690 S Main St, South Salt Lake, UT 84115 Phone: 801-587-2525 Fax: 801-261-0503

Jacob Stout, - Medicare Physician Assistant in South Salt Lake, UT