NPIMap

Individual provider Active NPI

Jacob Harry Pickle IV, MD

  • Gastroenterology Physician
  • Allentown, PA
National Provider Identifier
1174525117
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD03476SE Issued in PA
Practice address
3131 College Heights Blvd
Suite 1200
Allentown, PA 18104-4812
Phone
(610) 439-8551
Fax
(610) 439-1435
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD03476SE PA
Gastroenterology Physician 207RG0100X MD03476SE PA Primary

Addresses

Primary practice location

3131 College Heights Blvd
Suite 1200
Allentown, PA 18104-4812

Mailing address

3131 College Heights Blvd
Suite 1200
Allentown, PA 18104-4812
Phone (610) 439-8551

Other identifiers 1

IdentifierTypeStateIssuer
0011987300001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100824001153 PA Practitioner - GastroenterologyPractitioner - Internal Medicine 5496651275 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Hahnemann University College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates LTDGroup PAC ID 7416853288, 4 clinicians
Avicenna Physician Services IncGroup PAC ID 1153733944, 14 clinicians

Practice addresses (Care Compare)

3131 College Heights Blvd
Suite 1200
Allentown, PA 18104-4858
Phone (610) 439-8551

5148 Hamilton Blvd
Allentown, PA 18106-9788
Phone (610) 904-8100

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • St Luke'S Hospital - Upper Bucks Campus Hospital, Quakertown, PA, CCN 390035
  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • St Luke'S Miners Memorial Hospital Hospital, Coaldale, PA, CCN 390183

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy88
Upper gastrointestinal (GI) endoscopy for acid reflux83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD03476SEPAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avicenna Physician Services Inc Internal Medicine CurrentSince May 1, 2025 Accepting new patients
Gastroenterology Associates LTD Gastroenterology CurrentSince Jul 11, 1988 Accepting new patients

Locations

3147 College Heights Blvd
Allentown, PA 18104
Phone (610) 841-2432

5148 Hamilton Blvd
Allentown, PA 18106
Phone (610) 515-9994

3131 College Heights Blvd
Allentown, PA 18104
Phone (610) 439-8551

3131 College Heights Blvd
Ste 1200
Allentown, PA 18104
Phone (610) 439-8551

Interoperability endpoints

  • Direct secure messaging: jacob.pickle@443411168821252.direct.elationemr.com
  • Direct secure messaging: jacob.pickle@slpg.direct-sluhn.org

Organizations & group practices 2

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1174525117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 COLLEGE HEIGHTS BLVD",
            "address_2": "SUITE 1200",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044812",
            "telephone_number": "610-439-8551",
            "fax_number": "610-439-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 COLLEGE HEIGHTS BLVD",
            "address_2": "SUITE 1200",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044812",
            "telephone_number": "610-439-8551",
            "fax_number": "610-439-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKLE",
        "first_name": "JACOB",
        "middle_name": "HARRY",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD03476SE",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD03476SE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011987300001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.