Jacob W Phillips, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

320916 Issued in NY

Practice address

4201 Buffalo Road, Suite 1
North Chili, NY 14514-1256

Phone

(585) 594-5995

Fax

(585) 594-5425

NPI assigned

Jun 26, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Churchville-Chili Family Medicine LLCGroup PAC ID 5294957874, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCR / HCR Home Care Chha (Rochester) Home health agency, Rochester, NY, CCN 337257
• Rochester General Hospital Hospital, Rochester, NY, CCN 330125
• Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

Merit-based Incentive Payment System (MIPS)

Final score

96.62 of 100Reported as apm

Quality

74.51

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drphillips@ccfm.medentdirect.com

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.

• Churchville-Chili Family Medicine, LLC

  • Family Medicine Physician
  • North Chili, NY
  • NPI 1326231291
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• L Woerner Inc

  • Home Health Agency
  • Rochester, NY
  • NPI 1407083033
  Care Compare affiliation
• L Woerner Inc

  • Home Health Agency
  • Rochester, NY
  • NPI 1649285354
  Care Compare affiliation
• University of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1346285657
  Care Compare affiliation
• University of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1669126090
  Care Compare affiliation

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1730317868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505",
            "city": "NORTH CHILI",
            "state": "NY",
            "postal_code": "145140505",
            "telephone_number": "585-594-5995",
            "fax_number": "585-594-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 BUFFALO ROAD, SUITE 1",
            "city": "NORTH CHILI",
            "state": "NY",
            "postal_code": "145141256",
            "telephone_number": "585-594-5995",
            "fax_number": "585-594-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JACOB",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-26",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "320916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William J O'Neal, DMD
• Adam Olm-Shipman
• Vincent Panzera, DPT
• Henry M. Paszko, M.D.
• Shondell Lynette Peoples, LPN
• Katrina Phillips, RN
• Rainbow Medical Home Pediatrics, LLC
• Ashlyn Raines, DPT
• Alyssa Raniewicz, OTR/L
• Ethan Reff

• General Practice Physician in North Chili, NY
• Providers in North Chili, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.