JACOB O WARDWELL DO
NPI 1063723781
Family Medicine - Sports Medicine in San Francisco, CA

Q: What is Jacob Wardwell's NPI number?

The NPI number for Jacob Wardwell is 1063723781. It was assigned to this individual provider in the NPPES registry on June 28, 2010.

Q: What is Jacob Wardwell's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Q: Is Jacob Wardwell enrolled in Medicare?

No. Jacob Wardwell has opted out of Medicare through October 20, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Jacob Wardwell was last updated on February 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.

Active since June 28, 2010Opted out of Medicare · through Oct 20, 2026

THREE EMBARCADERO CENTER, LOBBY LEVEL, SAN FRANCISCO, CA 94111(415) 495-2225(415) 494-2228 Get Directions Write a Review

NPPES record last updated: February 21, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 21, 2018, Apr 1, 2017 (2 updates tracked since 2017).

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About Jacob O Wardwell Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB O WARDWELL DO (NPI 1063723781) is an individual sports medicine provider in San Francisco, California, licensed in California (12776) and active in the NPI registry since June 2010. He has opted out of Medicare through October 20, 2026 and remains eligible to order and refer and maintains a secondary practice location in San Francisco.

NPPES Registry Identity

NPI1063723781

Entity TypeIndividualMale

Primary Taxonomy207QS0010X

Provider Legal NameJACOB O WARDWELLCredential: DO

Location AddressTHREE EMBARCADERO CENTER, LOBBY LEVELSan Francisco, CA 94111

Mailing Address450 Sutter St Rm 1341San Francisco, CA 94108-4007 · (415) 606-0309 · Fax (415) 862-0626

Phone(415) 495-2225

Fax(415) 494-2228

Sole ProprietorNo

Enumeration DateJune 28, 2010

Last NPPES UpdateFebruary 21, 20182 updates tracked since enumeration

✔ NPI 1063723781 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

License✔ Licensed in CA · 12776

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

THREE EMBARCADERO CENTER, San Francisco, CA 94111

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Secondary Practice Location 1

Location 1Three Embarcadero Center, Lobby LevelSan Francisco, CA 94111 · Phone (415) 495-2225 · Fax (415) 494-2228

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jacob O Wardwell Do has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 20, 2014 through October 20, 2026.

Opt-Out Effective DateOctober 20, 2014

Opt-Out In Effect ThroughOctober 20, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94111 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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