Dr Jake Anthony Weisberg, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Portland, Oregon. His current practice location is
3181 Sw Sam Jackson Park Rd, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at
(503) 701-4624.
Dr Jake Anthony Weisberg is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1053060988.
Physician's Profile
| Full Name | Dr Jake Anthony Weisberg |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 3181 Sw Sam Jackson Park Rd, Portland, Oregon |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1053060988
- Provider Enumeration Date: 03/19/2022
- Last Update Date: 02/01/2025
Medicare PECOS Information:
- PECOS PAC ID: 8426597386
- Enrollment ID: I20250521001333
Medical Identifiers
Medical identifiers for Dr Jake Anthony Weisberg such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1053060988 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 208D00000X | General Practice | DO222057 (Oregon) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jake Anthony Weisberg allows following entities to bill medicare on his behalf.
| Entity Name | Signify Health Medical Associates Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20191220002077 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jake Anthony Weisberg is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Dr Jake Anthony Weisberg, DO 3264 Copley St, Simi Valley, CA 93063-2670 Ph: (805) 404-8018 | Dr Jake Anthony Weisberg, DO 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3098 Ph: (503) 701-4624 |
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