Jacob Putkowski, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9107020 Issued in FL

Practice address

1368 N University Dr
Plantation, FL 33322-4734

Phone

(954) 577-0001

NPI assigned

Feb 1, 2013

Last updated

Jan 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, CT, NY3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Danbury Hospital Hospital, Danbury, CT, CCN 070033
• Putnam Hospital Center Hospital, Carmel, NY, CCN 330273

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: jacob.putkowski@ghuc.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Shore Lij, Urgent Care, P.C.

  • Urgent Care Clinic/Center
  • Rockville Centre, NY
  • NPI 1679970891

  CT

  Medicare reassignment Care Compare group
• Ehs at Lakeside LLC

  • Hospitalist Physician
  • Belle Glade, FL
  • NPI 1275018673
  Medicare reassignment
• Elite Medical Services at Lakeside LLC

  • Emergency Medicine Physician
  • Belle Glade, FL
  • NPI 1992216568
  Medicare reassignment
• Emergency Physician Services of New York, P.C.

  • Emergency Medicine Physician
  • Poughkeepsie, NY
  • NPI 1093759847
  Medicare reassignment
• Emergency Physicians of Connecticut PC

  • Emergency Medicine Physician
  • Waterbury, CT
  • NPI 1902278906
  Medicare reassignment
• Paragon Contracting Services LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225071459

  FL

  Medicare reassignment
• Inphynet Contracting Services LLC

  • Emergency Medicine Physician
  • Delray Beach, FL
  • NPI 1073556767

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Danbury Hospital

  • Dental Clinic/Center
  • Danbury, CT
  • NPI 1003835935

  Hospital

  Care Compare affiliation
• Danbury Hospital

  • General Acute Care Hospital
  • Danbury, CT
  • NPI 1548293343
  Care Compare affiliation
• Putnam Hospital Center

  • General Acute Care Hospital
  • Carmel, NY
  • NPI 1972557379
  Care Compare affiliation

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1093054652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5229 N DIXIE HWY",
            "address_2": "APT 29C2",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333344028",
            "telephone_number": "203-300-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1368 N UNIVERSITY DR",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333224734",
            "telephone_number": "954-577-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTKOWSKI",
        "first_name": "JACOB",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-01",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107020",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027832",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sat P Punyani, MD
• David Florin Pupaza, MD
• Pupo Dental, Inc
• Pur Aesthetics (Samsara Aesthetics and Wellness)
• Subhash Ramchandra Puranik, M.D.
• Theresa Pyle
• Nancy Pyram-Bernard, D.O
• Balawal Qaiser, DO
• Quality Diagnostic & Medical Center Inc.
• Quality Health Care of Florida.LLC

• Physician Assistant in Plantation, FL
• Providers in Plantation, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.