Individual provider Active NPI

Jacob Siner, PA-C

  • Physician Assistant
  • Glen Burnie, MD
National Provider Identifier
1659815090
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C06281 Issued in MD
Practice address
301 Hospital Dr
Glen Burnie, MD 21061
Phone
(410) 787-4000
NPI assigned
Dec 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C06281 MD Primary

Addresses

Primary practice location

301 Hospital Dr
Glen Burnie, MD 21061

Mailing address

301 Hospital Dr
Glen Burnie, MD 21061-5803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20170207001014 MD Practitioner - Physician Assistant 1557644010 Reassigns benefits to 1 organization

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: jsiner359368@direct.umm.edu

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1480809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1659815090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-787-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINER",
        "first_name": "JACOB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-04",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C06281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.