Active NPI
Jake Andrew Coffman, PA-C
- Physician Assistant
- Williamsport, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA066501
- Practice address
- 1705 Warren Ave Ste 101-103
Williamsport, PA 17701-2647 - Phone
- (570) 321-2020
- NPI assigned
- Nov 25, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-06081 | NC | |
| Physician Assistant | 363A00000X | MA066501 | PA | Primary |
Addresses
Primary practice location
1705 Warren Ave Ste 101-103
Williamsport, PA 17701-2647
Mailing address
1201 Grampian Blvd
Williamsport, PA 17701-1900
Phone (570) 326-8723
Other practice location 1
131 Miller St
Winston Salem, NC 27103-2508
Phone (336) 716-8200
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jcoffman287920@direct.novanthealth.org | ||
| Direct Messaging Address | UPMCHospitals@upmc.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Phoenix Rehabilitation and Health Services Inc
Practice addresses (Care Compare)
1100 Grampian Blvd
Williamsport, PA 17701-1907
Phone (570) 326-8457
131 Miller St
Winston Salem, NC 27103-2508
Phone (336) 716-2734
2000 Westinghouse Dr
Cranberry Township, PA 16066-5238
451 River Ave
Williamsport, PA 17701-3722
Phone (570) 326-8457
Hospital & facility affiliations
- North Carolina Baptist Hospital
- Upmc Williamsport
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA066501 | PA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Forsyth Memorial Hospital Inc | Current | Accepting new patients | |
| Novant Medical Group, Inc. | Current | Accepting new patients | |
| Wake Forest University Health Sciences | Current | Accepting new patients | |
| Susquehanna Physician Services | Current | Accepting new patients | |
| Susquehanna Physician Services | Physician Assistant | Current | Accepting new patients |
| Forsyth Memorial Hospital, Inc. | Current | Accepting new patients | |
| Susquehanna Physician Services | Current | Accepting new patients | |
| Hartsville Hma Physician Management Inc | Past | Accepting new patients | |
| Novant Health Medical Group, LLC | Past | Accepting new patients | |
| Carolinas Pain Institute, PA | Past | Accepting new patients | |
| Susquehanna Physician Services | Past | Accepting new patients |
Locations
5380 US Highway 158
Ste 110
Advance, NC 27006
Phone (336) 893-3210
6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
2010 Baldwin Ln
Winston Salem, NC 27103
Phone (336) 277-1717
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
131 Miller St
Winston Salem, NC 27103
Phone (336) 716-4161
190 Kimel Park Dr
Ste 140
Winston Salem, NC 27103
Phone (336) 277-2225
305 E Lee Ave
Yadkinville, NC 27055
Phone (336) 679-2661
700 High St
Williamsport, PA 17701
Phone (570) 321-1000
1201 Grampian Blvd
Ste 2F
Williamsport, PA 17701
Phone (570) 320-7598
1705 Warren Ave
Ste 101103
Williamsport, PA 17701
1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723
1100 Grampian Blvd
#P
Williamsport, PA 17701
Phone (570) 326-8457
Interoperability endpoints
- upmchospitals@upmc.com
- jake.a.coffman@upmcdirect.com
Organizations & group practices 15
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.
-
- Pain Medicine Physician
- Williamsport, PA
- NPI 1639114689
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
-
- Cardiovascular Disease Physician
- Williamsport, PA
- NPI 1861431116
-
- Family Medicine Physician
- Winston Salem, NC
- NPI 1104548874
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Radiology Clinic/Center
- Mansfield, PA
- NPI 1073361564
-
- Adult Reconstructive Orthopaedic Surgery Physician
- Williamsport, PA
- NPI 1831395912
Physician Assistant
-
- Endocrinology, Diabetes & Metabolism Physician
- Kernersville, NC
- NPI 1417242439
-
- Cardiovascular Disease Physician
- Winston Salem, NC
- NPI 1932935475
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
- Pediatric Rehabilitation Medicine Physician
- Charlotte, NC
- NPI 1396366316
-
- Family Medicine Physician
- South Williamsport, PA
- NPI 1780631226
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Williamsport, PA
- NPI 1609801976
-
- Psychiatric Hospital Unit
- Williamsport, PA
- NPI 1649746488
-
- General Acute Care Hospital
- Williamsport, PA
- NPI 1740365097
-
- Psychiatric Hospital Unit
- Winston Salem, NC
- NPI 1063480531
-
- Rehabilitation Hospital Unit
- Winston Salem, NC
- NPI 1114995677
-
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1144211301
-
- Clinical Medical Laboratory
- Winston Salem, NC
- NPI 1609162098
Hospital
-
- Pediatric Adolescent Medicine Physician
- Winston Salem, NC
- NPI 1912179219
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772150400000",
"number": "1194199349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 GRAMPIAN BLVD",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177011900",
"telephone_number": "570-326-8723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 WARREN AVE STE 101-103",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177012647",
"telephone_number": "570-321-2020"
}
],
"practiceLocations": [
{
"address_1": "131 Miller St",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271032508",
"country_code": "US",
"telephone_number": "336-716-8200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COFFMAN",
"first_name": "JAKE",
"middle_name": "ANDREW",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-25",
"last_updated": "2026-02-27",
"certification_date": "2026-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-06081",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA066501",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jcoffman287920@direct.novanthealth.org",
"affiliation": "N",
"address_1": "5380 US Highway 158 Ste 110",
"city": "Advance",
"state": "NC",
"country_code": "US",
"postal_code": "270066979",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "UPMCHospitals@upmc.com",
"affiliation": "N",
"endpointDescription": "Secure UPMC Direct Address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "600 Grant St Fl 58",
"city": "Pittsburgh",
"state": "PA",
"country_code": "US",
"postal_code": "152192739",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Williamsport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.