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DR. JACOB ALAN WEATHERLY MD
NPI 1538520457
Pediatrics in San Diego, CA

Active since March 20, 2016PECOS Enrolled
6699 ALVARADO RD STE 2200, SAN DIEGO, CA 92120(619) 265-3400 Get Directions Write a Review

NPPES record last updated: June 19, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 19, 2023, Jul 3, 2019, Jun 23, 2016 and 1 more (4 updates tracked since 2016).

About Dr. Jacob Alan Weatherly Md NPPES

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

DR. JACOB ALAN WEATHERLY MD (NPI 1538520457) is an individual pediatrics provider in San Diego, California, licensed in California (A150920) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1538520457
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. JACOB ALAN WEATHERLYCredential: MD
Location Address6699 ALVARADO RD STE 2200San Diego, CA 92120-5253
Mailing Address6699 Alvarado Rd Ste 2200San Diego, CA 92120-5253
Phone(619) 265-3400
Sole ProprietorNo
Enumeration DateMarch 20, 2016
Last NPPES UpdateJune 19, 20234 updates tracked since enumeration
NPPES CertifiedJune 19, 2023
✔ NPI 1538520457 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A150920
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
6699 ALVARADO RD STE 2200, San Diego, CA 92120
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jacob Alan Weatherly 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.

Medicare Billing Reassignment

Medicare enrollment records show Jacob Weatherly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

County Of Santa Clara
388 mi
Federally Qualified Health Center (FQHC)
7475 CAMINO ARROYO
Gilroy, CA 95020
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1629301346 (California), NPI 1588721500 (California)
  • 2,460 clinicians in this Medicare group
NPI 1922093533 (408) 885-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92120 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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

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

HARRISON HOWARD PA
Physician Assistant
6699 ALVARADO RD STE 2200
SAN DIEGO, CA 92120
San Diego County (619) 265-3400

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 Weatherly's NPI number?

The NPI number for Jacob Weatherly is 1538520457. It was assigned to this individual provider in the NPPES registry on March 20, 2016.

Where is Jacob Weatherly located?

Jacob Weatherly practices at 6699 Alvarado Rd Ste 2200, San Diego, CA 92120. The listed phone number is (619) 265-3400.

What is Jacob Weatherly's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jacob Weatherly enrolled in Medicare?

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

Which organization bills Medicare for Jacob Weatherly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Weatherly reassigns Medicare benefits to County Of Santa Clara (Gilroy, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacob Weatherly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jacob Weatherly was last updated on June 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.