JACOB ANDREW PRUSSMAN
NPI 1679250575
Dentist - General Practice in Honolulu, HI

Q: What is Jacob Prussman's NPI number?

The NPI number for Jacob Prussman is 1679250575. It was assigned to this individual provider in the NPPES registry on July 3, 2023.

Q: What is Jacob Prussman's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Prussman was last updated on July 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 July 03, 2023PECOS Enrolled

1857 PALOLO AVE, HONOLULU, HI 96816(516) 673-8571 Get Directions Write a Review

NPPES record last updated: July 24, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Jul 24, 2026, Jul 3, 2023 (2 updates tracked since 2023).

On this page

About Jacob Andrew Prussman NPPES

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

JACOB ANDREW PRUSSMAN (NPI 1679250575) is an individual general practice provider in Honolulu, Hawaii, licensed in Hawaii (DT-3247) and active in the NPI registry since July 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679250575

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameJACOB ANDREW PRUSSMAN

Location Address1857 PALOLO AVEHonolulu, HI 96816-2925

Mailing Address1857 Palolo AveHonolulu, HI 96816-2925

Phone(516) 673-8571

Sole ProprietorYes

Enumeration DateJuly 3, 2023

Last NPPES UpdateJuly 24, 20262 updates tracked since enumeration

NPPES CertifiedJuly 24, 2026

✔ NPI 1679250575 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in HI · DT-3247

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1857 PALOLO AVE, Honolulu, HI 96816

Open in Google Maps ↗

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 Andrew Prussman 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 96816 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

$92.50 typical visit price

range $60.53 – $180.05

Typical copayment $23.12 (range $15.13 – $45.01)

Most-billed visit code 99203

Established Patient

$74.92 typical visit price

range $20.09 – $147.56

Typical copayment $18.73 (range $5.02 – $36.89)

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.

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 Prussman's NPI number?

The NPI number for Jacob Prussman is 1679250575. It was assigned to this individual provider in the NPPES registry on July 3, 2023.

Where is Jacob Prussman located?

Jacob Prussman practices at 1857 Palolo Ave, Honolulu, HI 96816. The listed phone number is (516) 673-8571.

What is Jacob Prussman's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Jacob Prussman enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jacob Prussman was last updated on July 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.