Individual provider Active NPI

Jacob David Burkart

  • Physician Assistant
  • Spokane, WA
National Provider Identifier
1457949448
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61559558 Issued in WA
Practice address
5633 N. Lidgerwood St
Spokane, WA 99208
Phone
(121) 091-0893
NPI assigned
Jan 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2521 WV
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA61559558 WA Primary

Addresses

Primary practice location

5633 N. Lidgerwood St
Spokane, WA 99208

Mailing address

5633 N Lidgerwood St
Spokane, WA 99208-1224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, WA2 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
I20211108001095 WV Practitioner - Physician Assistant 5799174009
I20250117001052 WA Practitioner - Physician Assistant 5799174009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Services P S Holy Emergency CenterGroup PAC ID 1052594314, 22 clinicians

Practice addresses (Care Compare)

5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone (509) 484-2460

Hospital & facility affiliations

  • Providence Holy Family Hospital Hospital, Spokane, WA, CCN 500077

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2521WVMDProfessional Counselor
PA61559558WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Community Hospital Assn., Inc. CurrentSince Nov 1, 2021 Accepting new patients
Princeton Community Hospital Assn., Inc CurrentSince Nov 1, 2021 Accepting new patients

Locations

401 E Vermillion St
Athens, WV 24712
Phone (304) 384-7325

Organizations & group practices 3

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 1

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": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1457949448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5633 N LIDGERWOOD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992081224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5633 N. LIDGERWOOD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99208",
            "telephone_number": "121-091-0893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKART",
        "first_name": "JACOB",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-05",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "2521",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61559558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.