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Jake Musashe

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

1725 W Harrison St Ste 970, Chicago, IL 60612-3828

PECOS Enrollment

Based on the most recent information from CMS, provider Jake Musashe is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1477066777
Provider Type
Individual
Full Name
Musashe, Jake
Credential
PA-C

Gender
Male
Sole Proprietor
No
Enumeration Date
11/8/2017
Last Updated
4/12/2021

Contact Information

Practice Location

1725 W Harrison St Ste 970, Chicago, IL 60612-3828

(312) 563-3447

Unlisted Fax

Mailing Location

1725 W Harrison St Ste 970, Chicago, IL 60612-3828

(312) 563-3447

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 085006426 Illinois

Jake Musashe

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Boris, Abigail

Reed, Kennedy Jean

Quemeneur, Alexis Caryl

Wolfinger, Richard Carl

Khan, Nazish

Johnson, Hannah Grace

Villaluna, Guia C.

Parikh, Pooja Chetan

Adesida, Adebowale Tolulade

Arens, Stacy Lynn