Wayne R Jacobs Jr.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA061359 Issued in PA

Practice address

435 River Ave
Williamsport, PA 17701-3722

Phone

(866) 995-3937

NPI assigned

Jan 6, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bernstein, Hilliker, Hartzell Eye Center, LLPGroup PAC ID 0244216018, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wjacobs@eccpa.intellechartdirect.net

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.

• Bernstein, Hilliker, Hartzell Eye Center, LLP

  • Ophthalmology Physician
  • Lewisburg, PA
  • NPI 1942390745
  Medicare reassignment Care Compare group
• Bernstein Hilliker Hartzell Eye Center LLP

  • Ambulatory Surgical Clinic/Center
  • Allenwood, PA
  • NPI 1245331628
  NPD
• Bernstein Hilliker Hartzell Eye Center, LLP

  • Optometrist
  • Lewisburg, PA
  • NPI 1275553570
  NPD (past)

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1003455163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 ENTERPRISE BLVD",
            "city": "ALLENWOOD",
            "state": "PA",
            "postal_code": "178109260",
            "telephone_number": "570-538-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 RIVER AVE",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013722",
            "telephone_number": "866-995-3937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "137 Jpm Rd",
            "address_purpose": "LOCATION",
            "city": "Lewisburg",
            "state": "PA",
            "postal_code": "178379313",
            "country_code": "US",
            "telephone_number": "866-995-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "WAYNE",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-06",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA061359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103739681",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wjacobs@eccpa.ecldirect.net",
            "affiliation": "Y",
            "affiliationName": "BERNSTEIN, HILLIKER, HARTZELL EYE CENTER, LLP",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "435 River Ave",
            "city": "Williamsport",
            "state": "PA",
            "country_code": "US",
            "postal_code": "177013722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bernadette Itle Crosby, LCSW
• Jessica Jackson, MS
• Victoria Marie Jackson, OTA/L
• Stephen Jacob
• Brad Jacobs, CRNA. DNP
• Jacobson Paulhamus DDS PC
• Kerri Michelle Jacobson, DC
• Stephanie James, BA
• Jamie Plocinski LCSW
• Honora Jankowski

• Medical Physician Assistant in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.