Jacob Wilson, OD in Tuba City, AZ - Medicare Optometrist Provider

Jacob Wilson, OD is a medicare enrolled "Optometrist" provider in Tuba City, Arizona. His current practice location is 2033-1 N Spruce, Tuba City, Arizona. You can reach out to his office (for appointments etc.) via phone at (602) 576-2812.

Jacob Wilson is licensed to practice in Arizona (license number 733279) 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 1740974088.

Contact Information

	Jacob Wilson, OD
	2033-1 N Spruce, Tuba City, AZ 86045
	(602) 576-2812
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jacob Wilson
Gender	Male
Speciality	Optometrist
Location	2033-1 N Spruce, Tuba City, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1740974088
Provider Enumeration Date: 06/08/2023
Last Update Date: 06/08/2023

Medicare PECOS Information:

PECOS PAC ID: 8527417187
Enrollment ID: I20231208000785

Medical Identifiers

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

Identifier	Type	State	Issuer
1740974088	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	733279 (Arizona)	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 Wilson allows following entities to bill medicare on his behalf.

Provider Name	Tuba City Regional Health Care Corporation
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1548294424 PECOS PAC ID: 4284542531 Enrollment ID: O20031105000107

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 Wilson 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 Wilson, OD 167 N Main St, Tuba City, AZ 86045 Ph: () -	Jacob Wilson, OD 2033-1 N Spruce, Tuba City, AZ 86045 Ph: (602) 576-2812

Reviews and Comments

Optometrist in Tuba City, AZ

Gay E Nord, OD Optometrist Medicare: Medicare Enrolled Practice Location: 167 North Main Street, Tuba City, AZ 86045 Phone: 928-283-2501 Fax: 928-283-2677
Breanne Michelle Flores, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 167 North Main Street, Tuba City, AZ 86045 Phone: 928-283-2781
Ronda L Olson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 167 North Main Street, Tuba City, AZ 86045 Phone: 928-283-2501 Fax: 928-283-2677
Lawrence E Richardson, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 167 North Main Street, Tuba City, AZ 86045 Phone: 928-283-2501 Fax: 928-283-2677
Patricia M Mccullough, OD Optometrist Medicare: Medicare Enrolled Practice Location: 167 Main Street, Tuba City, AZ 86045 Phone: 866-976-5941
Nancy A Nichols, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 167 North Main Street, Tuba City, AZ 86045 Phone: 928-283-2501 Fax: 928-283-2677

Jacob Wilson, OD - Medicare Optometrist in Tuba City, AZ