JACOB BOTTELBERGHE
NPI 1346894748
Physician Assistant in Marshall, MN

Q: What is Jacob Bottelberghe's NPI number?

The NPI number for Jacob Bottelberghe is 1346894748. It was assigned to this individual provider in the NPPES registry on July 25, 2019.

Q: What is Jacob Bottelberghe's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since July 25, 2019PECOS EnrolledAccepts Medicare Assignment

94/100

CMS Quality Rating

300 S BRUCE ST, MARSHALL, MN 56258(507) 537-9165 Get Directions Write a Review

NPPES record last updated: July 25, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jacob Bottelberghe NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB BOTTELBERGHE (NPI 1346894748) is an individual physician assistant in Marshall, Minnesota and active in the NPI registry since July 2019. He is enrolled in Medicare PECOS, is affiliated with Avera Marshall Regional Medical Ctr, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1346894748

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJACOB BOTTELBERGHE

Location Address300 S BRUCE STMarshall, MN 56258-1934

Mailing Address1107 300th StMinneota, MN 56264-1103

Phone(507) 537-9165

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateJuly 25, 2019

✔ NPI 1346894748 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

300 S BRUCE ST, Marshall, MN 56258

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Avera Health Plans, Medica, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacob Bottelberghe is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2961835368

PECOS Enrollment IDI20191125001728

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Avera Marshall Regional Medical Ctr

Critical Access Hospitals · Marshall, MN

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number241359

Location300 South Bruce StreetMarshall, MN 56258 · Lyon County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56258 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

84.79

Promoting Interoperability

98.22

Improvement Activities

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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