Mr Jacob Strange, PA-C is a
Physician Assistant based in Winnebago, Wisconsin. Mr Jacob Strange is licensed to practice in Wisconsin (license number 3818-23) and his current practice location is
1300 South Drive, Winnebago, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(920) 235-4910.
NPI number for Mr Jacob Strange is 1316396633 and his current mailing address is 1521 Cliffview Dr, Oshkosh, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1316396633.
Provider's Profile
| Full Name | Mr Jacob Strange |
|---|
| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 1300 South Drive, Winnebago, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1316396633
- Provider Enumeration Date: 06/07/2016
- Last Update Date: 07/21/2023
Medical Identifiers
Medical identifiers for Mr Jacob Strange such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1316396633 | NPI | - | NPPES |
| 3818-23 | Other | WI | WISCONSIN LICENSE |
| PA9109427 | Other | FL | FLORIDA LICENSE |
| 50.004667RX | Other | OH | OHIO LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | PA9109427 (Florida) | Secondary |
| 363A00000X | Physician Assistant | 50.004667RX (Ohio) | Secondary |
| 363A00000X | Physician Assistant | 3818-23 (Wisconsin) | 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. Mr Jacob Strange is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Jacob Strange, PA-C
1521 Cliffview Dr,
Oshkosh, WI 54901-2575
Ph: (330) 618-9628 | Mr Jacob Strange, PA-C
1300 South Drive,
Winnebago, WI 54985
Ph: (920) 235-4910 |
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