Nwi Mdvip Llc - Medicare Primary Care in Crown Point, IN

Nwi Mdvip Llc is a medicare enrolled primary clinic (Family Medicine) in Crown Point, Indiana. The current practice location for Nwi Mdvip Llc is 9150 E 109th Ave Ste 2b, Crown Point, Indiana. For appointments, you can reach them via phone at (219) 213-2947. The mailing address for Nwi Mdvip Llc is 9150 E 109th Ave Ste 2b, Crown Point, Indiana and phone number is (219) 306-0752.

Nwi Mdvip Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1538877972. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (219) 213-2947.

Contact Information

Nwi Mdvip Llc
9150 E 109th Ave Ste 2b
Crown Point
IN 46307-7686
(219) 213-2947
(219) 310-8175

Primary Care Clinic Profile

Full NameNwi Mdvip Llc
SpecialityFamily Medicine
Location9150 E 109th Ave Ste 2b, Crown Point, Indiana
Authorized Official Name and PositionBrent A Jacobus (OWNER)
Authorized Official Contact2193060752
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Nwi Mdvip Llc
9150 E 109th Ave Ste 2b
Crown Point
IN 46307-7686

Ph: (219) 306-0752
Nwi Mdvip Llc
9150 E 109th Ave Ste 2b
Crown Point
IN 46307-7686

Ph: (219) 213-2947

NPI Details:

NPI Number1538877972
Provider Enumeration Date11/14/2022
Last Update Date11/14/2022

Medicare PECOS Information:

Medicare PECOS PAC ID0042683690
Medicare Enrollment IDO20230301000520

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Medical Identifiers

Medical identifiers for Nwi Mdvip Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1538877972NPI-NPPES
200380090MedicaidIN
100200720MedicaidIN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Nwi Mdvip Llc acts as a billing entity for following providers:
Provider NameBrett A Brechner
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1629079108
PECOS PAC ID: 6002887049
Enrollment ID: I20040804000103

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Provider NameBrent A Jacobus
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1902807589
PECOS PAC ID: 2163494162
Enrollment ID: I20040810001164

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