Jacob Luke Hummel, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA062957 Issued in PA

Practice address

109 W Green St
Nanticoke, PA 18634-2212

Phone

(570) 579-0043

Fax

(570) 735-2608

NPI assigned

Nov 12, 2021

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Northeast Counseling Services

  • Clinic/Center
  • Hazle Township, PA
  • NPI 1649608530
  Medicare reassignment NPD
• Northeast Counseling Service

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Nanticoke, PA
  • NPI 1205437092
  NPD

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1083370191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W GREEN ST",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186342212",
            "telephone_number": "570-579-0043",
            "fax_number": "570-735-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W GREEN ST",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186342212",
            "telephone_number": "570-579-0043",
            "fax_number": "570-735-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMMEL",
        "first_name": "JACOB",
        "middle_name": "LUKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-12",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guardian Long Term Care Pharmacy Inc
• Heather Lasco Nutrition LLC
• Melanie Hill
• Richard A Hiscox, DO
• Jennifer L Houston, MS OTR/L
• Intermed Physicians Inc
• J.T. Huang, M.D. P.C
• Janusz Wolanin MD
• Bethany Lyn Jones, O.D.
• Gina Jorgensen, MSPT

• Physician Assistant in Nanticoke, PA
• Providers in Nanticoke, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.