Active NPI
Jacob M Agris, MD
- Neuroradiology Physician
- Erie, PA
National Provider Identifier
1619921178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuroradiology Physician
- License
- MD428507
- Practice address
- 1910 Sassafras St
Suite 200
Erie, PA 16502-2716 - Phone
- (814) 452-7809
- Fax
- (814) 452-7848
- NPI assigned
- May 20, 2006
- Last updated
- Mar 25, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuroradiology Physician | 2085N0700X | MD428507 | PA | Primary |
| Neuroradiology Physician | 2085N0700X | 0101236471 | VA |
Addresses
Primary practice location
1910 Sassafras St
Suite 200
Erie, PA 16502-2716
Mailing address
2 Shore Dr
Great Neck, NY 11021-1711
Phone (713) 705-2133
Other practice location 1
2 Shore Dr
Great Neck, NY 11021-1711
Phone (713) 705-2133
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101236471 | VA | MD | Neuroradiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Vincent Medical Education and Research Institute | Past | Accepting new patients | |
| MCV Associated Physicians | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Albion Family Practice
- Family Medicine Physician
- Albion, PA
- NPI 1558462259
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774396800000",
"number": "1619921178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 SHORE DR",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110211711",
"telephone_number": "713-705-2133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 SASSAFRAS ST",
"address_2": "SUITE 200",
"city": "ERIE",
"state": "PA",
"postal_code": "165022716",
"telephone_number": "814-452-7809",
"fax_number": "814-452-7848"
}
],
"practiceLocations": [
{
"address_1": "2 Shore Dr",
"address_purpose": "LOCATION",
"city": "Great Neck",
"state": "NY",
"postal_code": "110211711",
"country_code": "US",
"telephone_number": "713-705-2133",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AGRIS",
"first_name": "JACOB",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-20",
"last_updated": "2026-03-25",
"certification_date": "2026-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "PA",
"license": "MD428507",
"primary": true
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "VA",
"license": "0101236471",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.