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DR. JAKE KIESERMAN MD
NPI 1669056602
Internal Medicine in Philadelphia, PA

Active since May 06, 2021PECOS Enrolled
3900 WOODLAND AVE, PHILADELPHIA, PA 19104(215) 823-5800 Get Directions Write a Review

NPPES record last updated: June 26, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 26, 2024, Sep 15, 2021, May 6, 2021 (3 updates tracked since 2021).

About Dr. Jake Kieserman Md NPPES

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

DR. JAKE KIESERMAN MD (NPI 1669056602) is an individual internal medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD481943) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669056602
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. JAKE KIESERMANCredential: MD
Location Address3900 WOODLAND AVEPhiladelphia, PA 19104-4551
Mailing Address3400 Spruce StPhiladelphia, PA 19104-4238
Phone(215) 823-5800
Sole ProprietorNo
Enumeration DateMay 6, 2021
Last NPPES UpdateJune 26, 20243 updates tracked since enumeration
NPPES CertifiedJune 26, 2024
✔ NPI 1669056602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in PA · MD481943
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
3900 WOODLAND AVE, Philadelphia, PA 19104
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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. Jake Kieserman 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 Jake Kieserman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Penn - Medical Group
0.5 mi
Hospitalist
3400 SPRUCE ST
Philadelphia, PA 19104
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 752 clinicians in this Medicare group
NPI 1053447151 (215) 662-4000

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 19104 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

MEREDITH A SPINDLER MD
Psychiatry & Neurology (Neurology)
3900 WOODLAND AVE, PADRECC, #127
PHILADELPHIA, PA 19104
Philadelphia County (215) 823-5800
DENIS MICHAEL CAREY LCSW
Social Worker (Clinical)
3900 WOODLAND AVE
PHILADELPHIA, PA 19104
Philadelphia County (267) 292-7700
RONALD ANDREW SPOTTS CAADC
Counselor (Addiction (Substance Use Disorder))
3900 WOODLAND AVE, ADDICTION RECOVERY UNIT 7TH FLOOR
PHILADELPHIA, PA 19104
Philadelphia County (215) 823-5800
CAROL BUHRMAN RD
Dietitian, Registered (Nutrition, Gerontological)
3900 WOODLAND AVE
PHILADELPHIA, PA 19104
Philadelphia County (215) 823-5800
MS. CARLA PATRICE CLEMENTS RN, CRNP
Nurse Practitioner (Acute Care)
3900 WOODLAND AVE
PHILADELPHIA, PA 19104
Philadelphia County (215) 823-5800
DR. FAUZIA HUSSAIN PHARM.D.
Pharmacist (Pharmacotherapy)
3900 WOODLAND AVE, PHARMACY SERVICE #119
PHILADELPHIA, PA 19104
Philadelphia County (215) 823-4153
MR. FREDRICK W CLAUSS MPT
Physical Therapist
3900 WOODLAND AVE
PHILADELPHIA, PA 19104
Philadelphia County (215) 823-5800
DR. LEAH C JONES M.D.
Internal Medicine
3900 WOODLAND AVE
PHILADELPHIA, PA 19104
Philadelphia County (215) 823-5967

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 Jake Kieserman's NPI number?

The NPI number for Jake Kieserman is 1669056602. It was assigned to this individual provider in the NPPES registry on May 6, 2021.

Where is Jake Kieserman located?

Jake Kieserman practices at 3900 Woodland Ave, Philadelphia, PA 19104. The listed phone number is (215) 823-5800.

What is Jake Kieserman's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jake Kieserman enrolled in Medicare?

Yes. Jake Kieserman is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jake Kieserman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jake Kieserman reassigns Medicare benefits to University Of Penn - Medical Group (Philadelphia, PA). 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 Jake Kieserman'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 Jake Kieserman was last updated on June 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.