Individual provider Active NPI

Jacob Meisenburg, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Ripley, WV
National Provider Identifier
1851749949
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
10501 Issued in NY
Practice address
122 Pinnell St
Ripley, WV 25271-9101
Phone
(304) 372-2731
Fax
(304) 372-2749
NPI assigned
May 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 10501 NY Primary

Addresses

Primary practice location

122 Pinnell St
Ripley, WV 25271-9101

Mailing address

122 Pinnell St
Ripley, WV 25271-9101
Phone (304) 372-2731

Other identifiers 1

IdentifierTypeStateIssuer
10501OtherWVWEST VIRGINIA BOARD OF MEDICINE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230103001842 WV Practitioner - Podiatry 7719237130 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Western University of Health Sciences College of Dental Med, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health AssociationGroup PAC ID 1759291313, 69 clinicians

Practice addresses (Care Compare)

122 Pinnell St
Ripley, WV 25271-9101
Phone (304) 372-2731

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10501NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Association CurrentSince Nov 10, 2023 Accepting new patients
Logan General Hospital LLC CurrentSince Dec 1, 2022 Accepting new patients
Appalachia Pathology Consultants LLC Current Accepting new patients
Community Health Association CurrentSince Nov 10, 2023 Accepting new patients
Community Health Association Past Accepting new patients

Locations

79 Hospital Dr
Logan, WV 25601
Phone (304) 831-1594

20 Hospital Dr
Logan, WV 25601
Phone (304) 792-1101

174 Pinnell St
Ste C
Ripley, WV 25271
Phone (304) 372-1740

122 Pinnell St
Ripley, WV 25271
Phone (304) 373-1544

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1464566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1851749949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 PINNELL ST",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "252719101",
            "telephone_number": "304-372-2731",
            "fax_number": "304-372-2749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 PINNELL ST",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "252719101",
            "telephone_number": "304-372-2731",
            "fax_number": "304-372-2749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEISENBURG",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-30",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "10501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEST VIRGINIA  BOARD OF MEDICINE",
            "identifier": "10501",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ripley, WV

Sources for this page

Verify at the official NPI Registry.