JACOB WILLIAM RAIFSTANGER PHYSICIAN ASSISTANT
NPI 1679989479
Physician Assistant - Surgical in Rochester, NY

Q: What is Jacob Raifstanger's NPI number?

The NPI number for Jacob Raifstanger is 1679989479. It was assigned to this individual provider in the NPPES registry on July 1, 2014.

Q: What is Jacob Raifstanger's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Raifstanger was last updated on January 11, 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.

Active since July 01, 2014PECOS EnrolledAccepts Medicare Assignment

95.19/100

CMS Quality Rating

2655 RIDGEWAY AVE STE 460, ROCHESTER, NY 14626(585) 581-6790(585) 581-6793 Get Directions Write a Review

NPPES record last updated: January 11, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 11, 2023, Aug 6, 2019, May 13, 2019 (3 updates tracked since 2019).

On this page

About Jacob William Raifstanger Physician Assistant NPPES

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

JACOB WILLIAM RAIFSTANGER PHYSICIAN ASSISTANT (NPI 1679989479) is an individual surgical provider in Rochester, New York, licensed in New York (017837) and active in the NPI registry since July 2014. He is enrolled in Medicare PECOS, is affiliated with Champlain Valley Physicians Hospital Medical Ctr, and maintains a secondary practice location in Rochester.

NPPES Registry Identity

NPI1679989479

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameJACOB WILLIAM RAIFSTANGERCredential: PHYSICIAN ASSISTANT

Location Address2655 RIDGEWAY AVE STE 460Rochester, NY 14626-4296

Mailing Address100 Kings Hwy SRochester, NY 14617-5504 · (585) 922-1900

Phone(585) 581-6790

Fax(585) 581-6793

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateJuly 1, 2014

Last NPPES UpdateJanuary 11, 20233 updates tracked since enumeration

NPPES CertifiedJanuary 11, 2023

✔ NPI 1679989479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in NY · 017837

2655 RIDGEWAY AVE STE 460, Rochester, NY 14626

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Secondary Practice Location 1

Location 11425 Portland AveRochester, NY 14621-3001 · Phone (585) 922-3458 ext. 1

Other Identifiers 1

Medicaid03957908NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacob William Raifstanger Physician Assistant is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608096003

PECOS Enrollment IDI20240917005015

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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

88 services88 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

56 services56 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

43 services36 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

28 services24 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Champlain Valley Physicians Hospital Medical Ctr

Acute Care Hospitals · Plattsburgh, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330250

Location75 Beekman StreetPlattsburgh, NY 12901 · Clinton County

Emergency services Birthing friendly

Central Vermont Medical Center

Acute Care Hospitals · Barre, VT

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number470001

LocationBox 547Barre, VT 05641 · Washington County

Emergency services Birthing friendly

Univ. Of Vermont - Fletcher Allen Health Care

Acute Care Hospitals · Burlington, VT

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number470003

Location111 Colchester AveBurlington, VT 05401 · Chittenden County

Emergency services Birthing friendly

Northwestern Medical Center Inc

Acute Care Hospitals · Saint Albans, VT

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number470024

Location133 Fairfield StreetSaint Albans, VT 05478 · Franklin County

Emergency services Birthing friendly

Porter Hospital, Inc

Critical Access Hospitals · Middlebury, VT

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number471307

Location115 Porter DriveMiddlebury, VT 05753 · Addison County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.19/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

70.62

Promoting Interoperability

100

Improvement Activities

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 Raifstanger's NPI number?

The NPI number for Jacob Raifstanger is 1679989479. It was assigned to this individual provider in the NPPES registry on July 1, 2014.

Where is Jacob Raifstanger located?

Jacob Raifstanger practices at 2655 Ridgeway Ave Ste 460, Rochester, NY 14626. The listed phone number is (585) 581-6790.

What is Jacob Raifstanger's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Jacob Raifstanger enrolled in Medicare?

Yes. Jacob Raifstanger is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jacob Raifstanger accept?

Health plans from Anthem Blue Cross and Blue Shield list Jacob Raifstanger as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jacob Raifstanger affiliated with any hospitals?

According to CMS data, Jacob Raifstanger is affiliated with Champlain Valley Physicians Hospital Medical Ctr, Central Vermont Medical Center, Univ. Of Vermont - Fletcher Allen Health Care, Northwestern Medical Center Inc and Porter Hospital, Inc.

When was this NPI record last updated?

The NPPES record for Jacob Raifstanger was last updated on January 11, 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.