Jacob Eugene Phillips, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9105852 Issued in FL

Practice address

1801 Lee Rd Ste 304
Winter Park, FL 32789-2101

Phone

(321) 765-4373

Fax

(407) 542-0666

NPI assigned

Jan 10, 2011

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 FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Axis Medical Services LLC

  • Neurological Surgery Physician
  • Winter Park, FL
  • NPI 1538024047
  NPD (past)

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1306140017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 LEE RD STE 304",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892101",
            "telephone_number": "321-765-4373",
            "fax_number": "407-542-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 LEE RD STE 304",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892101",
            "telephone_number": "321-765-4373",
            "fax_number": "407-542-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JACOB",
        "middle_name": "EUGENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-10",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivien Doan Pham, MD
• Chau-Ha Phan, PHARMD
• Susan Phelps, LCSW
• Philippians Management Co. (Senior Helpers)
• Stephanie E. Philips, MSW
• Jennifer Phillips, CCC-SLP
• Katherine Mary Phillips, BCBA
• Kayla R Phillips
• Lascells Martin Phillips, LCSW
• Matthew Phillips

• Physician Assistant in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.