Individual ProviderAnshu JacobPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address51 N 39th St, Philadelphia, PA 19104-2640(215) 662-8000(224) 425-2615PECOS EnrollmentBased on the most recent information from CMS, provider Anshu Jacob is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1306667423Provider TypeIndividualFull NameJacob, AnshuCredentialPA-CGenderFemaleSole ProprietorNoEnumeration Date10/21/2024Last Updated10/21/2024Contact InformationPractice LocationPractice Address51 N 39th St, Philadelphia, PA 19104-2640Phone(215) 662-8000FaxUnlisted FaxMailing LocationMailing Address1180 Cedar Creek Dr, Lake Zurich, IL 60047-1833Phone(224) 425-2615FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363AM0700XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseMA066100Pennsylvania