MAURA KELLEY JACOB PA-C NPI 1174101893

NPI Information

NPI: 1174101893
Provider Name: MAURA KELLEY JACOB, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: ALLEGHENY CLINIC

PECOS Registration: Yes

Address:
1307 FEDERAL ST STE 300
PITTSBURGH, PA
ZIP 15212
Phone: (412) 281-1757
Get Directions

Maura Kelley Jacob, PA-C is a medical physician assistant in Pittsburgh, PA with 4 years of experience. Maura Kelley Jacob, PA-C NPI is 1174101893. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1307 FEDERAL ST STE 300
PITTSBURGH, PA
ZIP 15212-769
Phone: (412) 281-1757
Fax: (412) 281-7274

The NPI 1174101893 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/1/2021 and was last updated on 9/21/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		MA062209	PENNSYLVANIA	No
2	363AM0700X	Physician Assistant	Medical	MA062209	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	15402951	OTHER		CAQH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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