JACOB TANNER KOBERNICK PA-C
NPI 1942093695
Physician Assistant in Sun City West, AZ

Active since May 27, 2025PECOS EnrolledAccepts Medicare Assignment
14520 W GRANITE VALLEY DR STE 210, SUN CITY WEST, AZ 85375(866) 974-2673(866) 939-2673 Get Directions Write a Review

NPPES record last updated: August 27, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jacob Tanner Kobernick Pa-c NPPES

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

JACOB TANNER KOBERNICK PA-C (NPI 1942093695) is an individual physician assistant in Sun City West, Arizona, licensed in Arizona (11158) and active in the NPI registry since May 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1942093695
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJACOB TANNER KOBERNICKCredential: PA-C
Location Address14520 W GRANITE VALLEY DR STE 210Sun City West, AZ 85375-5855
Mailing Address18444 N 25th Ave Ste 310Phoenix, AZ 85023-1266 · (866) 974-2673 · Fax (866) 939-2673
Fax(866) 939-2673
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateMay 27, 2025
Last NPPES UpdateAugust 27, 2025
NPPES CertifiedAugust 27, 2025
NPI 1942093695 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in AZ · 11158
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.

14520 W GRANITE VALLEY DR STE 210, Sun City West, AZ 85375

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 Tanner Kobernick Pa-c 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 ID3870097710
PECOS Enrollment IDI20250916000406
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 85375 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
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.

Physician Assistant
14520 W GRANITE VALLEY DR STE 210
SUN CITY WEST, AZ 85375
Orthopaedic Surgery
14520 W GRANITE VALLEY DR STE 210
SUN CITY WEST, AZ 85375
Physician Assistant
14520 W GRANITE VALLEY DR STE 210
SUN CITY WEST, AZ 85375
Physician Assistant (Surgical)
14520 W GRANITE VALLEY DR STE 210
SUN CITY WEST, AZ 85375
Community/Behavioral Health
14520 W GRANITE VALLEY DR STE 210
SUN CITY WEST, AZ 85375
Orthopaedic Surgery
14520 W GRANITE VALLEY DR STE 210
SUN CITY WEST, AZ 85375
Physician Assistant (Surgical)
14520 W GRANITE VALLEY DR STE 210
SUN CITY WEST, AZ 85375
Physician Assistant
14520 W GRANITE VALLEY DR STE 210
SUN CITY WEST, AZ 85375

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 Kobernick's NPI number?

The NPI number for Jacob Kobernick is 1942093695. It was assigned to this individual provider in the NPPES registry on May 27, 2025.

Where is Jacob Kobernick located?

Jacob Kobernick practices at 14520 W Granite Valley Dr Ste 210, Sun City West, AZ 85375. The listed phone number is (866) 974-2673.

What is Jacob Kobernick's specialty?

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

Is Jacob Kobernick enrolled in Medicare?

Yes. Jacob Kobernick 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.

When was this NPI record last updated?

The NPPES record for Jacob Kobernick was last updated on August 27, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.