Jacob Vance
NPI 1104513522ActiveIndividual· Pharmacist· Mukwonago, WI
Pharmacist in Mukwonago, Wisconsin, licensed in WI, with an NPI issued in April 2023. Part D covered 27 prescriptions written in 2024, 0% of them generic.
Overview
| NPI | 1104513522 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Apr 18, 2023 |
| Last updated in NPPES | Apr 18, 2023 |
| Certified by provider | Apr 18, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacist Primary | 183500000X | 22126 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 27 · 27 30-day fills |
|---|---|
| Patients | 24 |
| Total drug cost | $2,763 |
| Generic share | 0% of claims |
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All 18 pharmacists in Mukwonago · All pharmacists in Wisconsin