Jacob A Wolff, PAC MHS

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10005066 Issued in WA

Practice address

101 W 8TH Ave
Spokane, WA 99205-4805

Phone

(509) 474-3131

NPI assigned

Sep 27, 2006

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 WA, ID2 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 2

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain West Derm - Blackhart PLLC 103 clinicians

Practice addresses (Care Compare)

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.

• Mountain West Derm - Blackhart PLLC

  • Dermatology Physician
  • Spokane Valley, WA
  • NPI 1013557933

  WA

  Medicare reassignment Care Compare group NPD
• Mountain West Derm-Blackhart, PLLC

  • Dermatology Physician
  • Boise, ID
  • NPI 1548758501

  ID

  Medicare reassignment Care Compare group
• Spokane Emergency Care Physicians PLLC

  • Emergency Medicine Physician
  • Spokane, WA
  • NPI 1912564055

  WA

  Medicare reassignment
• Mountain West Derm - Blackhart PLLC

  • Ambulatory Surgical Clinic/Center
  • Spokane Valley, WA
  • NPI 1619517539
  Care Compare group
• Mountain West Derm - Blackhart PLLC

  • Dermatology Physician
  • Anchorage, AK
  • NPI 1124670088
  Care Compare group
• Mountain West Derm - Blackhart PLLC

  • Dermatology Physician
  • Georgetown, TX
  • NPI 1366018848
  Care Compare group
• Mountain West Derm - Blackhart PLLC

  • Dermatology Physician
  • Bend, OR
  • NPI 1447764741
  Care Compare group
• Mountain West Derm - Blackhart PLLC

  • MOHS-Micrographic Surgery Physician
  • Reno, NV
  • NPI 1740633015
  Care Compare group
• Advanced Dermatology and Skin Surgery PLLC

  • Clinical Medical Laboratory
  • Spokane Valley, WA
  • NPI 1972579845
  NPD
• Mountain West Derm-Blackhart, PLLC

  • Dermatology Physician
  • Tigard, OR
  • NPI 1316656994
  NPD

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1164513305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 N HUTCHINSON RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992122444",
            "telephone_number": "509-456-7414",
            "fax_number": "509-624-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992054805",
            "telephone_number": "509-474-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "JACOB",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PAC MHS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "TA10005066",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Robert Wolfe, M.D.
• Branda Wolff
• Brett Wolff, MA, LMHC
• Danielle Erin Wolff, MD
• Hannah Wolff, MS, LMHC
• James Jessel Wolff, LICSW-A
• Mikayla Wolff, M.S
• Brenda Wolfley, OTRL
• Deneese Marie Wolford, SUDP
• Andrea Wolfram

• All providers in Spokane, WA
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.