Jacob Wesley Groseth, DPT is a medicare enrolled "Physical Medicine & Rehabilitation" in Yulee, Florida. His current practice location is
463688 State Road 200 Ste 9, Yulee, Florida. You can reach out to his office (for appointments etc.) via phone at
(904) 261-4414.
Jacob Wesley Groseth is licensed to practice in Florida (license number PT33205) 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 1881023539.
Provider's Profile
| Full Name | Jacob Wesley Groseth |
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| Gender | Male |
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| Speciality | Physical Medicine & Rehabilitation |
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| Location | 463688 State Road 200 Ste 9, Yulee, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1881023539
- Provider Enumeration Date: 11/04/2013
- Last Update Date: 12/14/2017
Medicare PECOS Information:
- PECOS PAC ID: 3870906241
- Enrollment ID: I20201231000858
Medical Identifiers
Medical identifiers for Jacob Wesley Groseth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1881023539 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363AS0400X | Physician Assistant - Surgical | 145866 (Florida) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | PT33205 (Florida) | 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. Jacob Wesley Groseth allows following entities to bill medicare on his behalf.
| Entity Name | Concierge Physio Llc |
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| Entity Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Entity Identifiers | NPI Number: 1013559632
PECOS PAC ID: 4082047667
Enrollment ID: O20191212002095 |
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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 Wesley Groseth 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 |
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Jacob Wesley Groseth, DPT
280 Exempla Cir,
Lafayette, CO 80026-3370
Ph: (303) 338-4545 | Jacob Wesley Groseth, DPT
463688 State Road 200 Ste 9,
Yulee, FL 32097-0304
Ph: (904) 261-4414 |
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