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Jacob Philip Graham

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

200 Lothrop St, Pittsburgh, PA 15213-2536

PECOS Enrollment

This provider is enrolled in PECOS as JACOB GRAHAM.

Based on the most recent information from CMS, provider Jacob Philip Graham 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 2 days ago.

Profile Details

Provider ID
1508558677
Provider Type
Individual
Full Name
Graham, Jacob Philip
Credential
PA

Gender
Male
Sole Proprietor
No
Enumeration Date
5/25/2023
Last Updated
5/25/2023

Contact Information

Practice Location

200 Lothrop St, Pittsburgh, PA 15213-2536

(585) 775-9368

Unlisted Fax

Mailing Location

6960 Pelham Rise, Victor, NY 14564-9633

(585) 775-9368

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Jacob Philip Graham

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Kostka, Rebecca Marie

Petrosky, Angela Lynn

Liberto, Kathryn

Quammen, Christopher W

Marszalek, Joan

Arrington, Megan

Kerin, Samantha

Mcgowan, Caitlin Paige

Tomsko, Devyn Nicole

Sulava, Natalie Kate