Individual provider Active NPI

Jacob William Kobrin, PA-C

  • Medical Physician Assistant
  • Schenectady, NY
National Provider Identifier
1568192730
Registry record updated Jun 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1101 Nott St
Schenectady, NY 12308-2489
Phone
(518) 243-4000
NPI assigned
Jun 12, 2022
Last updated
Jun 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

1101 Nott St
Schenectady, NY 12308-2489

Mailing address

1101 Nott St
Schenectady, NY 12308-2489
Phone (518) 243-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20240411003997 CO Practitioner - Physician Assistant 5991187593 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Community Emergency Services of Colorado, Inc. CurrentSince May 1, 2024 Accepting new patients
Usacs of Colorado Inc CurrentSince Feb 6, 2024 Accepting new patients
Usacs of Colorado Inc CurrentSince Feb 6, 2024 Accepting new patients
Premier Emergency Services, Inc CurrentSince May 1, 2024 Accepting new patients

Locations

7000 E Hampden Ave
Denver, CO 80224
Phone (330) 925-4199

7700 S Broadway
Littleton, CO 80122
Phone (303) 269-4786

2551 W 84th Ave
Westminster, CO 80031
Phone (303) 202-1280

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1654992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654992000000",
    "number": "1568192730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 NOTT ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082489",
            "telephone_number": "518-243-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 NOTT ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082489",
            "telephone_number": "518-243-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBRIN",
        "first_name": "JACOB",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-12",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.