Look up the most recent NPI and PECOS records

Samantha Jacobs

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

4815 Liberty Ave Ste 340, Pittsburgh, PA 15224-2156

PECOS Enrollment

Based on the most recent information from CMS, provider Samantha Jacobs is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 10:04 AM.

Profile Details

Provider ID
1508402959
Provider Type
Individual
Full Name
Jacobs, Samantha
Gender
Female

Sole Proprietor
Yes
Enumeration Date
11/20/2019
Last Updated
5/25/2022

Contact Information

Practice Location

4815 Liberty Ave Ste 340, Pittsburgh, PA 15224-2156

(412) 681-4401

Unlisted Fax

Mailing Location

247 Morewood Ave, Pittsburgh, PA 15213-1861

(412) 622-0290

(412) 681-7605

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License SP021890 Pennsylvania
Code 363L00000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 95013319 California

Samantha Jacobs

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Ranella, Elizabeth

Burkey, Jennifer Lee

Krause, Shelby Mari

Urbanowicz, Clyde Richard

Cook, Diana Marie

Brennan, Christine Anne

Palko-Grieggs, Leanne Marie

Dean, Nicole Marie

Kowalski, Vanessa

Rent, Jonathan Andrew