Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jacob A Petrosky, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1881959013

Dr. Jacob A Petrosky, MD is a General Surgery in Danville, Pennsylvania. Graduated from University of Kansas School of Med (KC/WICH/SAL) in 2012, 14 years ago. Practices with Southeast Alaska Regional Health Consortium, a 368-clinician group, works from 5 locations, accepts Medicare assignment and offers telehealth. Licensed in Florida, Mississippi, Ohio and Pennsylvania and 1 more.

Years since qualifying
14
Trained at
University of Kansas School of Med (KC/WICH/SAL)
Licensed in
FL, MS, OH, PA, TN
In the registry since
2012
Specialties on file
7
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

100 N Academy Ave
Danville, PA 17822
Phone: (570) 271-6361
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 4240 Bethel Rd Ste 200, Olive Branch, MS 38654-8737 — (901) 758-7970
  • 13207 Ravenna Rd, Chardon, OH 44024-7032 — (440) 214-3111
  • 793 W State St, Columbus, OH 43222-1551 — (913) 667-9099
  • 1325 Eastmoreland Ave Ste 310, Memphis, TN 38104-7544 — (901) 758-7970

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence ME149924 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (OH)
Surgery Physician Taxonomy 208600000X · Licence 35.126975 (OH)
Surgery Physician Taxonomy 208600000X · Licence MD459469 (PA)
Surgery Physician Taxonomy 208600000X · Licence 32954 (MS)
Hospitalist Physician Taxonomy 208M00000X · Licence 35.126975 (OH)
Surgery Physician Taxonomy 208600000X · Licence 69473 (TN)

Record details

NPI number1881959013
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 13, 2012
Last updated in NPPESOctober 21, 2025
Certification dateOctober 21, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated 2012 (14 years in practice)
Group practice Southeast Alaska Regional Health Consortium — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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