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

Jacob Spivack

Individual provider Physician Assistant · NPI 1134912652

Jacob Spivack is a Physician Assistant in Elkins Park, Pennsylvania. Qualified in 2024, 2 years ago. Practices with Eastern Pennsylvania Physician Alliance, LLC, a 110-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
2
Licensed in
PA
In the registry since
2025

Practice location Address checks out

8360 Old York Rd
Elkins Park, PA 19027-1576
Phone: (215) 780-1400
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA066230 (PA)

Record details

NPI number1134912652
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 27, 2025
Last updated in NPPESMay 27, 2025
Certification dateMay 27, 2025
Mailing address8360 Old York Rd, Elkins Park, PA 19027-1576

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Eastern Pennsylvania Physician Alliance, Llc — 110 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Elkins Park