Individual provider Active NPI

Jacob A Gardner, MD

  • Diagnostic Radiology Physician
  • Hershey, PA
National Provider Identifier
1992025654
Registry record updated Jul 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD451895 Issued in PA
Practice address
500 University Dr
Hershey, PA 17033-2360
Phone
(717) 531-8521
NPI assigned
Jun 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD451895 PA Primary

Addresses

Primary practice location

500 University Dr
Hershey, PA 17033-2360

Mailing address

500 University Dr
Hershey, PA 17033-2360
Phone (717) 531-8521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140815001518 PA Practitioner - Diagnostic Radiology 2264659184 Reassigns benefits to 4 organizations
I20251003000168 FL Practitioner - Diagnostic Radiology 2264659184 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Temple University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Radiology Imaging at Lake Mary LLCGroup PAC ID 1254311137, 273 clinicians
Penn State Health Medical Group LLCGroup PAC ID 8729351077, 720 clinicians
Florida Hospital Medical Group IncGroup PAC ID 0042383200, 329 clinicians
The Milton S Hershey Medical Center Physicians GroupGroup PAC ID 3870405483, 1,606 clinicians

Practice addresses (Care Compare)

1480 W Orange Blossom TRL
Adventhealth Imaging Apopka
Apopka, FL 32712-2637
Phone (407) 200-5440

1551 Future Way
Adventhealth Imaging
Celebration, FL 34747-4489
Phone (407) 303-4041

1919 E Hwy 50 101
Adventhealth Imaging Center Clermon
Clermont, FL 34711-1975
Phone (352) 717-3738

2200 Fowler Grove Blvd
Suite 60
Winter Garden, FL 34787-5597
Phone (407) 200-0538

2200 Good Hope Rd
Suite 1076
Enola, PA 17025-1210
Phone (717) 981-8160

235 E Princeton St
Suite 100
Orlando, FL 32804-5554
Phone (407) 303-1414

2488 E Irlo Bronson Memorial Hwy
Ahi Partin Settlement
Kissimmee, FL 34744-4948
Phone (407) 200-5440

25 S Terry Ave
Suite 220
Orlando, FL 32805-1843
Phone (407) 641-2446

328 Locust St
Pittsburgh, PA 15218-1457
Phone (407) 200-2355

500 Universidy Dr
Hershey, PA 17033-2360
Phone (717) 531-8365

661 E Altamonte Dr
Suite 130
Altamonte Springs, FL 32701-5102
Phone (407) 303-2155

Hospital & facility affiliations

  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256
  • Adventhealth Waterman Hospital, Tavares, FL, CCN 100057
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • Adventhealth Deland Hospital, Deland, FL, CCN 100045

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD451895PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC Diagnostic Radiology CurrentSince Nov 21, 2021 Accepting new patients
The Milton S Hershey Medical Center Physician Group Diagnostic Radiology CurrentSince Jul 1, 2014 Accepting new patients
Florida Radiology Imaging at Lake Mary, LLC Diagnostic Radiology CurrentSince Sep 22, 2025 Accepting new patients
Florida Hospital Medical Group Inc Diagnostic Radiology CurrentSince Sep 22, 2025 Accepting new patients
Florida Radiology Imaging at Lake Mary, LLC Diagnostic Radiology CurrentSince Sep 22, 2025 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients

Locations

900 Winderley Pl
Ste 1100
Maitland, FL 32751
Phone (407) 200-1606

235 E Princeton St
Ste 100
Orlando, FL 32804
Phone (407) 303-1414

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

423 N 21st St
Ste 202
Camp Hill, PA 17011
Phone (717) 763-9880

2200 Good Hope Rd
Ste 1076
Enola, PA 17025
Phone (717) 981-8160

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

Networks

  • Freedom Health HMO Network

Organizations & group practices 7

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 7

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": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1992025654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JACOB",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-04",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD451895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.