Mr Jacob Strange, PA-C is a medicare enrolled "Physician Assistant" in Winnebago, Wisconsin. His current practice location is
1300 South Drive, Winnebago, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(920) 235-4910.
Mr Jacob Strange is licensed to practice in Wisconsin (license number 3818-23) 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 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 | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1316396633
- Provider Enumeration Date: 06/07/2016
- Last Update Date: 07/21/2023
Medicare PECOS Information:
- PECOS PAC ID: 5597050591
- Enrollment ID: I20160829002569
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
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 |
|---|
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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