Individual provider Active NPI

Jacob Matthew Weber, MD

  • Student in an Organized Health Care Education/Training Program
  • Beavercreek, OH
National Provider Identifier
1326621855
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
36897 Issued in NE
Practice address
725 University Blvd FL 2
Beavercreek, OH 45324-2640
Phone
(937) 567-6198
Fax
(937) 641-2563
NPI assigned
May 3, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 36897 NE Primary

Addresses

Primary practice location

725 University Blvd FL 2
Beavercreek, OH 45324-2640

Mailing address

725 University Blvd FL 2
Beavercreek, OH 45324-2640
Phone (937) 567-6198

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230801001014 OH Order and Referring Only - Family PracticePractitioner - Family Practice 7810271384

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36897NEMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: jacob.weber.1@415.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1326621855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 UNIVERSITY BLVD FL 2",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "453242640",
            "telephone_number": "937-567-6198",
            "fax_number": "937-641-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 UNIVERSITY BLVD FL 2",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "453242640",
            "telephone_number": "937-567-6198",
            "fax_number": "937-641-2563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "JACOB",
        "middle_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-03",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NE",
            "license": "36897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.