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MR. JACOB LEE WONDERLICH PA
NPI 1255446878
Physician Assistant in Davenport, FL

Active since August 21, 2006PECOS Enrolled
40100 HIGHWAY 27, DAVENPORT, FL 33837(863) 422-4971 Get Directions Write a Review

NPPES record last updated: July 7, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Jacob Lee Wonderlich Pa NPPES

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

MR. JACOB LEE WONDERLICH PA (NPI 1255446878) is an individual physician assistant in Davenport, Florida, licensed in Florida (PA9103414) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255446878
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. JACOB LEE WONDERLICHCredential: PA
Location Address40100 HIGHWAY 27Davenport, FL 33837
Mailing Address8390 Champions Gate Boulevard, Suite 306Champions Gate, FL 33896 · (407) 390-1677 · Fax (407) 390-1765
Phone(863) 422-4971
Sole ProprietorNo
Enumeration DateAugust 21, 2006
Last NPPES UpdateJuly 7, 2021
NPPES CertifiedJuly 7, 2021
✔ NPI 1255446878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in FL · PA9103414
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
40100 HIGHWAY 27, Davenport, FL 33837
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Other Identifiers 1

Medicaid292248700FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Oscar Health Maintenance Organization of Florida, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Jacob Lee Wonderlich Pa 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33837 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
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 20

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

DR. JORDAN MARTINEZ MD
Emergency Medicine
40100 HIGHWAY 27
DAVENPORT, FL 33837
Polk County (863) 422-4971
DR. VENKEDESH RAJU M.D
Pediatrics
40100 HIGHWAY 27
DAVENPORT, FL 33837
Polk County (407) 975-0412
RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND
Radiology (Diagnostic Radiology)
40100 HIGHWAY 27
DAVENPORT, FL 33837
Polk County (863) 422-4971
MRS. KASEY ACKLIN CRNP
Nurse Practitioner
40100 HIGHWAY 27
DAVENPORT, FL 33837
Polk County (863) 422-4971
SEAN TYRONE USTIC PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
40100 HIGHWAY 27
DAVENPORT, FL 33837
Polk County (863) 419-2366
JANET GARCIA GARCIA RN
Registered Nurse (Registered Nurse First Assistant)
40100 HIGHWAY 27
DAVENPORT, FL 33837
Polk County (863) 422-4971
DR. EDGAR JAMES MORALES M.D
Pathology (Anatomic Pathology & Clinical Pathology)
40100 HIGHWAY 27
DAVENPORT, FL 33837
Polk County (216) 904-2791
DR. ROBERT CRUZ VERGARA MD
Emergency Medicine
40100 HIGHWAY 27
DAVENPORT, FL 33837
Polk County (863) 422-4971

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 Wonderlich's NPI number?

The NPI number for Jacob Wonderlich is 1255446878. It was assigned to this individual provider in the NPPES registry on August 21, 2006.

Where is Jacob Wonderlich located?

Jacob Wonderlich practices at 40100 Highway 27, Davenport, FL 33837. The listed phone number is (863) 422-4971.

What is Jacob Wonderlich's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jacob Wonderlich enrolled in Medicare?

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

What insurance does Jacob Wonderlich accept?

Health plans from AvMed, Oscar Health Maintenance Organization of Florida and Oscar Insurance Company list Jacob Wonderlich as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacob Wonderlich was last updated on July 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.