JACOB ELI ANDERSON M.D.
NPI 1285088682
Student in an Organized Health Care Education/Training Program in Syracuse, NY

Q: What is Jacob Anderson's NPI number?

The NPI number for Jacob Anderson is 1285088682. It was assigned to this individual provider in the NPPES registry on April 21, 2016.

Q: What is Jacob Anderson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jacob Anderson was last updated on April 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 April 21, 2016PECOS Enrolled

750 E ADAMS ST, SYRACUSE, NY 13210(315) 464-4830 Get Directions Write a Review

NPPES record last updated: April 21, 2016. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Jacob Eli Anderson M.d. NPPES

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

JACOB ELI ANDERSON M.D. (NPI 1285088682) is an individual student in an organized health care education/training program in Syracuse, New York and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285088682

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACOB ELI ANDERSONCredential: M.D.

Location Address750 E ADAMS STSyracuse, NY 13210-2306

Mailing Address750 E Adams StSyracuse, NY 13210-2306

Phone(315) 464-4830

Sole ProprietorYes

Enumeration DateApril 21, 2016

✔ NPI 1285088682 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.

750 E ADAMS ST, Syracuse, NY 13210

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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 Eli Anderson M.d. 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.

DAVID M KANTER MD

Physical Medicine & Rehabilitation