Individual provider Active NPI

Jacob Lang, PA-C

  • Physician Assistant
  • Leesburg, FL
National Provider Identifier
1710515952
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9121984 Issued in FL
Practice address
600 E Dixie Ave
Leesburg, FL 34748-5925
Phone
(352) 559-5051
NPI assigned
Apr 1, 2020
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9121984 FL Primary
Surgical Physician Assistant 363AS0400X 4561 SC

Addresses

Primary practice location

600 E Dixie Ave
Leesburg, FL 34748-5925

Mailing address

257 McDowell St
Asheville, NC 28803-2606
Phone (828) 258-1121

Other practice location 1

1506 Spring St
Greenwood, SC 29646-4071
Phone (864) 725-7900

Other practice location 2

257 McDowell St
Asheville, NC 28803-2606
Phone (828) 258-1121

Other practice location 3

3437 Caroline St
Saint Louis, MO 63104-1111
Phone (309) 303-8048

Other practice location 4

2728 Sunset Blvd Ste 105
West Columbia, SC 29169-4839
Phone (803) 936-7095

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlang196902@direct.lexmed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20221101001797 SC Practitioner - Physician Assistant 0042628539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111

1506 Spring St
Greenwood, SC 29646-4071
Phone (864) 725-7900

160 Academy Ave
Greenwood, SC 29646-3808
Phone (864) 223-8090

2728 Sunset Blvd
Suite 105
West Columbia, SC 29169-4839
Phone (803) 936-7045

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc CurrentSince Nov 12, 2025 Accepting new patients
Self Medical Group CurrentSince Sep 1, 2022 Accepting new patients
Self Medical Group CurrentSince Sep 1, 2022 Accepting new patients
Lexington Health Inc Current Accepting new patients
Lexington Health Inc CurrentSince Nov 12, 2025 Accepting new patients
Self Medical Group Physician Assistant Past Accepting new patients
Lexington Health Inc Past Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

1506 Spring St
Greenwood, SC 29646
Phone (864) 227-3117

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

2728 Sunset Blvd
Ste 105
West Columbia, SC 29169
Phone (803) 936-7045

Interoperability endpoints

  • Direct secure messaging: jlang196902@direct.lexmed.com
  • Direct secure messaging: jlang538570@selfregional.direct-ci.net

Organizations & group practices 9

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 6

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1710515952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 MCDOWELL ST",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288032606",
            "telephone_number": "828-258-1121",
            "fax_number": "828-252-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485925",
            "telephone_number": "352-559-5051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1506 Spring St",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296464071",
            "country_code": "US",
            "telephone_number": "864-725-7900",
            "fax_number": "864-725-7910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "257 McDowell St",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288032606",
            "country_code": "US",
            "telephone_number": "828-258-1121",
            "fax_number": "828-252-6114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3437 Caroline St",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041111",
            "country_code": "US",
            "telephone_number": "309-303-8048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2728 Sunset Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "291694839",
            "country_code": "US",
            "telephone_number": "803-936-7095",
            "fax_number": "803-936-7908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANG",
        "first_name": "JACOB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9121984",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "4561",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlang196902@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2728 Sunset Blvd Ste 105",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.