JAKE ROLDAN RESTIVO
NPI 1477351690
Physician Assistant in Washington, DC

Q: What is Jake Restivo's NPI number?

The NPI number for Jake Restivo is 1477351690. It was assigned to this individual provider in the NPPES registry on March 4, 2025.

Q: What is Jake Restivo's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jake Restivo was last updated on August 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since March 04, 2025PECOS Enrolled

2300 I ST NW, WASHINGTON, DC 20052(202) 994-2987 Get Directions Write a Review

NPPES record last updated: August 19, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Jake Roldan Restivo NPPES

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

JAKE ROLDAN RESTIVO (NPI 1477351690) is an individual physician assistant in Washington, District Of Columbia and active in the NPI registry since March 2025. The provider is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477351690

Entity TypeIndividual

Primary Taxonomy363A00000X

Provider Legal NameJAKE ROLDAN RESTIVO

Location Address2300 I ST NWWashington, DC 20052-0011

Mailing Address1561 Division StWest Charlton, NY 12010-6810

Phone(202) 994-2987

Sole ProprietorNo

Enumeration DateMarch 4, 2025

Last NPPES UpdateAugust 19, 2025

NPPES CertifiedAugust 19, 2025

✔ NPI 1477351690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

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.

2300 I ST NW, Washington, DC 20052

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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)

Jake Roldan Restivo 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 20052 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

$100.31 typical visit price

range $65.18 – $194.86

Typical copayment $25.07 (range $16.29 – $48.71)

Most-billed visit code 99203

Established Patient

$80.66 typical visit price

range $21.40 – $158.88

Typical copayment $20.16 (range $5.35 – $39.72)

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.

LINDSAY KAUFMAN

Physician Assistant