NPIMap

Individual provider Active NPI

Ron Mathew Jacob, M.D.

  • Cardiovascular Disease Physician
  • York, PA
National Provider Identifier
1639340722
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD420245 Issued in PA
Practice address
30 Monument Rd # 1100
York, PA 17403-5024
Phone
(717) 851-2441
Fax
(717) 851-3521
NPI assigned
Mar 17, 2008
Last updated
Apr 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD420245 PA Primary

Addresses

Primary practice location

30 Monument Rd # 1100
York, PA 17403-5024

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-2441

Other identifiers 1

IdentifierTypeStateIssuer
1021930250001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080530000150 PA Practitioner - Cardiovascular Disease (Cardiology) 6800966094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

1 Hospital Dr
Lewisburg, PA 17837-9350
Phone (570) 522-4264

1001 S George St
York, PA 17403-3676

1001 S George St 2ND Floor
Wellspan Pulmonary and Sleep Medicine
York, PA 17403-3676
Phone (717) 851-2465

12 St Paul Dr
Chambersburg, PA 17201-1035

1227 Baltimore St
Hanover, PA 17331-4406
Phone (717) 812-7559

147 Gettys St
Gettysburg, PA 17325-2534
Phone (717) 334-2121

169 Martin Ave
Ephrata, PA 17522-1724
Phone (717) 733-0311

25 Monument Rd
York, PA 17403-5049

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

30 Monument Rd
Suite 1100
York, PA 17403-5024
Phone (717) 812-2480

35 Monument Rd
York, PA 17403-5074

4 TH and Walnut STS
2ND Floor
Lebanon, PA 17042-6123
Phone (717) 270-3751

40 V Twin Dr
Gettysburg, PA 17325-7878

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince May 2, 2022 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince May 2, 2022 Accepting new patients
MRI Group, LLP Past Accepting new patients

Locations

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1600 S George St
York, PA 17403
Phone (717) 848-3615

Interoperability endpoints

  • Direct secure messaging: rjacob293734@wellspan.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1639340722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-851-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MONUMENT RD # 1100",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035024",
            "telephone_number": "717-851-2441",
            "fax_number": "717-851-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "RON",
        "middle_name": "MATHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-17",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD420245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021930250001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.