Individual ProviderJacob JodatPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address10625 W North Ave Ste 101b, Wauwatosa, WI 53226-2315(414) 877-5350(262) 951-1750PECOS EnrollmentBased on the most recent information from CMS, provider Jacob Jodat is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1447986575Provider TypeIndividualFull NameJodat, JacobCredentialPA-CGenderMaleSole ProprietorNoEnumeration Date7/29/2022Last Updated7/29/2022Contact InformationPractice LocationPractice Address10625 W North Ave Ste 101b, Wauwatosa, WI 53226-2315Phone(414) 877-5350FaxUnlisted FaxMailing LocationMailing Address854 Delaware Ave Apt C, Grafton, WI 53024-9479Phone(262) 951-1750FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted IssuerWisconsin