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MR. JACOB BURNELL PENHOLLOW FNP-BC
NPI 1285453936
Nurse Practitioner - Family in Bradford, PA

Active since October 09, 2024PECOS EnrolledAccepts Medicare Assignment
116 INTERSTATE PKWY, BRADFORD, PA 16701(814) 362-8274 Get Directions Write a Review

NPPES record last updated: October 9, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Jacob Burnell Penhollow Fnp-bc NPPES

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

MR. JACOB BURNELL PENHOLLOW FNP-BC (NPI 1285453936) is an individual family provider in Bradford, Pennsylvania, licensed in New York (351530) and active in the NPI registry since October 2024. He is enrolled in Medicare PECOS, maintains a secondary practice location in Olean, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1285453936
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMR. JACOB BURNELL PENHOLLOWCredential: FNP-BC
Location Address116 INTERSTATE PKWYBradford, PA 16701-1036
Mailing Address1160 Chili Ave Ste 200Rochester, NY 14624-3035 · (585) 426-4990
Phone(814) 362-8274
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateOctober 9, 2024
NPPES CertifiedOctober 9, 2024
✔ NPI 1285453936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 351530
116 INTERSTATE PKWY, Bradford, PA 16701
Open in Google Maps ↗

Secondary Practice Location 1

Location 1515 Main StOlean, NY 14760-1598 · Phone (716) 373-2600

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Jacob Burnell Penhollow Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2769904085
PECOS Enrollment IDI20251114002220
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 16701 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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 20

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

KATHRYN ELENCHIN
Nurse Anesthetist, Certified Registered
116 INTERSTATE PKWY
BRADFORD, PA 16701
McKean County (814) 362-8674
OLEAN GENERAL HOSPITAL
Psychiatry & Neurology (Psychiatry)
116 INTERSTATE PKWY
BRADFORD, PA 16701
McKean County (814) 368-4143
MRS. JULIE LYNN GALBRAITH MPT
Physical Therapist
116 INTERSTATE PKWY
BRADFORD, PA 16701
McKean County (814) 362-8264
OLEAN GENERAL HOSPITAL
Family Medicine
116 INTERSTATE PKWY
BRADFORD, PA 16701
McKean County (814) 368-4143
OLEAN GENERAL HOSPITAL
Pediatrics
116 INTERSTATE PKWY, SUITE 42
BRADFORD, PA 16701
McKean County (814) 362-8390
CYNTHIA SIMMS RN, CDE
Registered Nurse (Diabetes Educator)
116 INTERSTATE PKWY
BRADFORD, PA 16701
McKean County (814) 368-8717
NATHANIEL LARS GRAHAM M.D.
Surgery
116 INTERSTATE PKWY, SUITE 31
BRADFORD, PA 16701
McKean County (814) 368-7125
REBECCA MILLER MD
Pediatrics
116 INTERSTATE PKWY, FOURTH FLOOR
BRADFORD, PA 16701
McKean County (814) 362-8390

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 Penhollow's NPI number?

The NPI number for Jacob Penhollow is 1285453936. It was assigned to this individual provider in the NPPES registry on October 9, 2024.

Where is Jacob Penhollow located?

Jacob Penhollow practices at 116 Interstate Pkwy, Bradford, PA 16701. The listed phone number is (814) 362-8274.

What is Jacob Penhollow's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jacob Penhollow enrolled in Medicare?

Yes. Jacob Penhollow is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jacob Penhollow was last updated on October 9, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.