DR. JACOB DANIEL CARLISLE DDS
NPI 1437718301
Dentist in Benton Harbor, MI
About Dr. Jacob Daniel Carlisle Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JACOB DANIEL CARLISLE DDS (NPI 1437718301) is an individual dentist in Benton Harbor, Michigan, licensed in Michigan (2901600138) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Jacob Daniel Carlisle Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jacob Carlisle reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Benton Harbor, MI 49022
- Reassigned Medicare billing, Michigan enrollment
- 101 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49022 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jacob Carlisle's NPI number?
The NPI number for Jacob Carlisle is 1437718301. It was assigned to this individual provider in the NPPES registry on June 13, 2019.
Where is Jacob Carlisle located?
Jacob Carlisle practices at 800 M 139, Benton Harbor, MI 49022. The listed phone number is (855) 869-6900.
What is Jacob Carlisle's specialty?
The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.
Is Jacob Carlisle enrolled in Medicare?
Yes. Jacob Carlisle is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jacob Carlisle's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Carlisle reassigns Medicare benefits to Intercare Community Health Network (Benton Harbor, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacob Carlisle's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jacob Carlisle accept?
Health plans from Antidote Health Plan of Ohio, Inc., Best Life, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 8 other insurers list Jacob Carlisle as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jacob Carlisle was last updated on June 13, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Jacob Daniel Carlisle, DDS · NPI 1437718301
Dentist provider in Benton Harbor, Michigan. Individual provider, active in the CMS NPPES registry since June 13, 2019.
## Identity
- **NPI:** 1437718301 (Entity type: Individual)
- **Enumerated:** June 13, 2019
- **Primary specialty:** Dentist · taxonomy 122300000X
- **State license:** 2901600138 (Michigan)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 800 M 139, Benton Harbor, MI 49022-3881
- **Phone:** (855) 869-6900
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Intercare Community Health Network (NPI 1902235328, Benton Harbor, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 13, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1437718301) · Data from the CMS NPPES public registry.