JACOB WILLIAM FISHBAUGH (PA-C) – Physician Assistant, NPI 1710554274
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for JACOB WILLIAM FISHBAUGH (PA-C)
334 Smith Ave
Thomasville, GA 317925533
Phone: (574) 904-6141
Type: Location
419 S Coral St
Kalkaska, MI 496462503
Phone: (231) 258-7530
Fax: (231) 258-7555
Type: Location
829 N Center Ave Ste 210
Gaylord, MI 497351599
Phone: (319) 350-3382
Fax: (231) 935-0569
Type: Location
224 Park Ave
Frankfort, MI 496359658
Phone: (231) 935-0338
Fax: (231) 935-0568
Type: Location
1619 Anderson Rd
Petoskey, MI 497709256
Phone: (231) 935-0338
Fax: (231) 935-3421
Type: Location
1105 SIXTH ST
TRAVERSE CITY, MI 496842386
Phone: (231) 392-0773
Fax: (231) 935-5885
Type: Mailing
3537 W FRONT ST STE A
TRAVERSE CITY, MI 496847942
Phone: (231) 935-0338
Fax: (231) 935-0569
Type: Location
30087 REDFIELD ST
NILES, MI 491205963
Phone: (574) 904-6141
Type: Mailing
334 SMITH AVE
THOMASVILLE, GA 317925533
Phone: (574) 904-6141
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $239.
Total Amount is formed as General ($239) + Research ($0) + Ownership ($0) = $239.
Last reported payment date: 2024-02-07 • Largest payer in this snapshot: Ardelyx, Inc. ($125).
Total Amount
$239
General + Research + Ownership
Payments
2
Total payment records
General Amount
$239
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Ardelyx, Inc. | $125 |
| Bayer Healthcare Pharmaceuticals Inc. | $114 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-07-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230717002348 | I | Physician Assistant | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 58 | 52 | $0 |
Insurance plans in this area (ZIP 31792)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| N E U R O S U R G E R Y | MI | |
| Internal Medicine | IL | |
| Family Practice | MI |
Reviews
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