Mr Jacob Burnell Penhollow, FNP-BC in Bradford, PA

Mr Jacob Burnell Penhollow, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Bradford, Pennsylvania. His current practice location is 116 Interstate Pkwy, Bradford, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at (814) 362-8274.

Mr Jacob Burnell Penhollow is licensed to practice in New York (license number 351530) 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 1285453936.

Contact Information

	Mr Jacob Burnell Penhollow, FNP-BC
	116 Interstate Pkwy, Bradford, PA 16701-1036
	(814) 362-8274
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Jacob Burnell Penhollow
Gender	Male
Speciality	Nurse Practitioner - Family
Location	116 Interstate Pkwy, Bradford, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1285453936
Provider Enumeration Date: 10/09/2024
Last Update Date: 10/09/2024

Medicare PECOS Information:

PECOS PAC ID: 2769904085
Enrollment ID: I20250317001325

Medical Identifiers

Medical identifiers for Mr Jacob Burnell Penhollow such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1285453936	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	351530 (New York)	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. Mr Jacob Burnell Penhollow allows following entities to bill medicare on his behalf.

Entity Name	Delphi Healthcare Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003075029 PECOS PAC ID: 9537229661 Enrollment ID: O20081119000839

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. Mr Jacob Burnell Penhollow 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
Mr Jacob Burnell Penhollow, FNP-BC 1160 Chili Ave Ste 200, Rochester, NY 14624-3035 Ph: (585) 426-4990	Mr Jacob Burnell Penhollow, FNP-BC 116 Interstate Pkwy, Bradford, PA 16701-1036 Ph: (814) 362-8274

Reviews and Comments

Nurse Practitioner Nurses in Bradford, PA

Darlene G Venezia Skaggs, MSN,NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1001 E. Main Sreet, Bradford, PA 16701 Phone: 814-368-1000 Fax: 814-368-1008
Karen Marie Kline, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 110 Campus Dr, Bradford, PA 16701 Phone: 814-362-6536 Fax: 814-817-2113
Andrew Davidson, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 116 Interstate Pkwy, Bradford, PA 16701 Phone: 214-368-9600
Mrs. Tammy Michelle Haley, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 70 1/2 Mechanic Street, Bradford, PA 16701 Phone: 814-368-6129 Fax: 814-368-6174
Ms. Karen Mcclain, ANP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 116 Interstate Pkwy Ste 41, Bradford, PA 16701 Phone: 814-368-4143
Becky Mckeirnan-seefeldt, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 116 Interstate Pkwy, Bradford, PA 16701 Phone: 814-362-8390

Mr Jacob Burnell Penhollow, FNP-BC - Medicare Nurse Practitioner in Bradford, PA