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

Mr. Jacob M. Fraker, PA

Individual provider Physician Assistant · NPI 1770565723

Mr. Jacob M. Fraker, PA is a Physician Assistant in South Bend, Indiana. Qualified in 2002, 24 years ago. Practices with Central Indiana Orthopedics LLC, a 146-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
24
Licensed in
IN
In the registry since
2005
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

53880 Carmichael Dr
South Bend, IN 46635-1567
Phone: (574) 247-9441
Fax: (574) 247-9442
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Additional practice locations (3)

  • 303 S Nappanee St Ste F, Elkhart, IN 46514-2066 — (574) 246-9441
  • 60160 Bodnar Blvd, Mishawaka, IN 46544-9338 — (574) 247-9441
  • 2349 Lake Ave Ste 201, Plymouth, IN 46563-7837 — (574) 247-9441

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10000686A (IN)

Record details

NPI number1770565723
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 16, 2005
Last updated in NPPESSeptember 3, 2024
Certification dateSeptember 3, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Central Indiana Orthopedics Llc — 146 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in South Bend