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JACOB PATRICK DALTON DO
NPI 1083400014
Student in an Organized Health Care Education/Training Program in Wyoming, MI

Active since April 16, 2025PECOS Enrolled
5900 BYRON CENTER AVE SW, WYOMING, MI 49519(616) 252-7078(616) 252-4953 Get Directions Write a Review

NPPES record last updated: April 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacob Patrick Dalton Do NPPES

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

JACOB PATRICK DALTON DO (NPI 1083400014) is an individual student in an organized health care education/training program in Wyoming, Michigan and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083400014
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACOB PATRICK DALTONCredential: DO
Location Address5900 BYRON CENTER AVE SWWyoming, MI 49519-9606
Mailing Address5900 Byron Center Ave SwWyoming, MI 49519-9606 · (616) 252-7078 · Fax (616) 252-4953
Phone(616) 252-7078
Fax(616) 252-4953
Sole ProprietorNo
Enumeration DateApril 16, 2025
Last NPPES UpdateApril 19, 2025
NPPES CertifiedApril 19, 2025
✔ NPI 1083400014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
5900 BYRON CENTER AVE SW, Wyoming, MI 49519
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Patrick Dalton Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

MATTHEW AARON ERCK DO
Internal Medicine
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
AMANDA BRONSON DO
Student in an Organized Health Care Education/Training Program
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7078
GANESH KUMAR DO
Student in an Organized Health Care Education/Training Program
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
DR. SARAH PRATT DO
Student in an Organized Health Care Education/Training Program
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
SAMANTHA BLAIR PA-C
Physician Assistant
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (812) 909-7200
CASSANDRA PAIGE FRITCH NP
Nurse Practitioner (Family)
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
DR. TRISTAN J WORTHINGTON DO
Family Medicine
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
MRS. KELLY ANN MURPHY DNP, FNP-C
Nurse Practitioner (Family)
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-3900

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 Jacob Dalton's NPI number?

The NPI number for Jacob Dalton is 1083400014. It was assigned to this individual provider in the NPPES registry on April 16, 2025.

Where is Jacob Dalton located?

Jacob Dalton practices at 5900 Byron Center Ave SW, Wyoming, MI 49519. The listed phone number is (616) 252-7078.

What is Jacob Dalton's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jacob Dalton enrolled in Medicare?

Yes. Jacob Dalton is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Dalton was last updated on April 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.