Frederick P Jaecklein, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

049842 Issued in MI

Practice address

1414 W. Fair Avenue
Ste 201
Marquette, MI 49855

Phone

(906) 225-4500

Fax

(906) 225-3919

NPI assigned

Nov 17, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• DLP Marquette Physician Practices Inc

  dba Marquette General Family Medicine - Marquette

  • Obesity Medicine (Internal Medicine) Physician
  • Marquette, MI
  • NPI 1487902995
  Medicare reassignment NPD
• DLP Marquette Physician Practices Inc

  dba Marquette General Heart and Vascular Institute

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Marquette, MI
  • NPI 1073861431
  NPD
• DLP Marquette Physician Practices Inc

  dba UP Health System Pediatric Specialists

  • Rural Health Clinic/Center
  • Marquette, MI
  • NPI 1205635760
  NPD
• Alzheimer's Disease and Related Disorders Association, Inc

  dba Alzheimer's Association- Greater Michigan Chapter

  • Voluntary or Charitable Agency
  • Southfield, MI
  • NPI 1801097522
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1306828009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "916-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W. FAIR AVENUE",
            "address_2": "STE 201",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-225-4500",
            "fax_number": "906-225-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAECKLEIN",
        "first_name": "FREDERICK",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "MI",
            "license": "049842",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "049842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110030846",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "381358036011",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3138366",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Jackson-Johnson, RN
• Bradley A Jackson, PT
• Cornesha Jackson
• James D. Jackson Jr., D.D.S.
• Jessica M Jackson, O.D.
• James D. Jackson DDS PC
• James L Christiansen MD PC
• James P Vanlandschoot
• James R Lovell M.D., P.C.
• James W Gallagher DPM (Superior Foot & Ankle)

• Internal Medicine Physician in Marquette, MI
• Providers in Marquette, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.