Jacob Spivack

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA066230 Issued in PA

Practice address

8360 Old York Rd
Elkins Park, PA 19027-1576

Phone

(215) 780-1400

NPI assigned

May 27, 2025

Last updated

May 27, 2025By the provider in NPPES

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastern Pennsylvania Physician Alliance, LLCGroup PAC ID 8325478662, 112 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Eastern Pennsylvania Physician Alliance LLC

  • Neurology Physician
  • Clarion, PA
  • NPI 1902440621

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Drexel University

  dba Speech-Language Institute

  • Hearing and Speech Clinic/Center
  • Elkins Park, PA
  • NPI 1538564927
  NPD (past)
• Salus University Hearing Vision Balance Clinic

  • Audiologist
  • Elkins Park, PA
  • NPI 1154785293
  NPD (past)

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1134912652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8360 OLD YORK RD",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8360 OLD YORK RD",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271576",
            "telephone_number": "215-780-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVACK",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Aimee Souder, CRNP
• Sousan Pharmacy Inc
• Sharon M Sowinski-Mueller, DO
• Larry Wayne Spector, D.O.
• Speech Finders Pediatric Therapy, LLC
• Fiona Stavri, MD
• Gerry Stefanatos, D.PHIL.
• Gina Lynn Stone, CRNP
• Susan Strasbaugh
• Elaine Minsun Sun

• Physician Assistant in Elkins Park, PA
• Providers in Elkins Park, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.
• 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.