JACOB FITZGERALD WOODROOF MD
NPI 1326780578
Student in an Organized Health Care Education/Training Program in Philadelphia, PA

Q: What is Jacob Woodroof's NPI number?

The NPI number for Jacob Woodroof is 1326780578. It was assigned to this individual provider in the NPPES registry on April 8, 2022.

Q: What is Jacob Woodroof'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 Woodroof was last updated on April 8, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 08, 2022PECOS Enrolled

1015 WALNUT ST STE 620, PHILADELPHIA, PA 19107(215) 955-6864(215) 955-2878 Get Directions Write a Review

NPPES record last updated: April 8, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Jacob Fitzgerald Woodroof Md NPPES

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

JACOB FITZGERALD WOODROOF MD (NPI 1326780578) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1326780578

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACOB FITZGERALD WOODROOFCredential: MD

Location Address1015 WALNUT ST STE 620Philadelphia, PA 19107-5005

Mailing Address1015 Walnut St Ste 620Philadelphia, PA 19107-5005 · (215) 955-6864 · Fax (215) 955-2878

Phone(215) 955-6864

Fax(215) 955-2878

Sole ProprietorYes

Enumeration DateApril 8, 2022

NPPES CertifiedApril 8, 2022

✔ NPI 1326780578 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.

1015 WALNUT ST STE 620, Philadelphia, PA 19107

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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 Fitzgerald Woodroof Md 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.

ZABECCA BRINSON M.D.

Student in an Organized Health Care Education/Training Program