Individual provider Active NPI

Jake Andrew Coffman, PA-C

  • Physician Assistant
  • Williamsport, PA
National Provider Identifier
1194199349
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA066501 Issued in PA
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

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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, PA2 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

Enrollment IDStateProvider typePAC IDDetails
I20160223002336 NC Practitioner - Physician Assistant 9436454857 Reassigns benefits to 3 organizations
I20250908002256 PA Practitioner - Physician Assistant 9436454857 Reassigns benefits to 2 organizations

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
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

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 Hospital, Winston-Salem, NC, CCN 340047
  • Upmc Williamsport Hospital, Williamsport, PA, CCN 390045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA066501PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Nov 5, 2018 Accepting new patients
Forsyth Memorial Hospital Inc CurrentSince Nov 5, 2018 Accepting new patients
Novant Medical Group, Inc. CurrentSince Nov 5, 2018 Accepting new patients
Wake Forest University Health Sciences CurrentSince Mar 9, 2026 Accepting new patients
Susquehanna Physician Services CurrentSince Sep 1, 2025 Accepting new patients
Susquehanna Physician Services Physician Assistant CurrentSince Sep 1, 2025 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Nov 5, 2018 Accepting new patients
Susquehanna Physician Services CurrentSince Sep 2, 2025 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

  • Direct secure messaging: upmchospitals@upmc.com
  • Direct secure messaging: 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.

View all 15

Hospital & facility affiliations 12

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

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

Verify at the official NPI Registry.