DR. JAKE ANTHONY WEISBERG DO
NPI 1053060988
Student in an Organized Health Care Education/Training Program in Portland, OR
About Dr. Jake Anthony Weisberg Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JAKE ANTHONY WEISBERG DO (NPI 1053060988) is an individual student in an organized health care education/training program in Portland, Oregon and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Jake Anthony Weisberg Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jake Weisberg's NPI number?
The NPI number for Jake Weisberg is 1053060988. It was assigned to this individual provider in the NPPES registry on March 19, 2022.
Where is Jake Weisberg located?
Jake Weisberg practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 701-4624.
What is Jake Weisberg's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Jake Weisberg enrolled in Medicare?
Yes. Jake Weisberg is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Jake Weisberg was last updated on February 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Jake Anthony Weisberg, DO · NPI 1053060988
Student in an Organized Health Care Education/Training Program provider in Portland, Oregon. Individual provider, active in the CMS NPPES registry since March 19, 2022.
## Identity
- **NPI:** 1053060988 (Entity type: Individual)
- **Enumerated:** March 19, 2022
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3181 SW SAM JACKSON PARK RD, Portland, OR 97239-3098
- **Phone:** (503) 701-4624
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** February 1, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1053060988) · Data from the CMS NPPES public registry.