MR. JACOB JONATHAN WHITE (PA) – Physician Assistant, NPI 1265818884

MR. JACOB JONATHAN WHITE (PA) is a healthcare provider. based in Chicago, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 085005589 (IL). The NPI Number for MR. JACOB JONATHAN WHITE (PA) is 1265818884

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
MR. JACOB JONATHAN WHITE (PA)
NPI
1265818884
Phone
Not provided
Address
5645 W ADDISON ST
Enumeration Date
5 August 2015
Last Update Date
5 August 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7732827000
Graduation Year
2015 (11 years ago)
PAC ID
0143536094
Group Practice PAC ID
2860716685
Professional Enrollment ID
I20150909000055
Address ID
IL606344403CH5645XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

Provider Addresses for MR. JACOB JONATHAN WHITE (PA)

  • 5645 W ADDISON ST

    CHICAGO, IL 606344403

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2015-09-09

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150909000055IPhysician AssistantILTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60634)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860716685View full group profile
NameSpecialtyState
Internal Medicine, Gastroenterology, Internal MedicineIL
Emergency MedicineIL
Emergency MedicineOH
Emergency Medicine, Addiction MedicineIL
Emergency MedicineIL
Emergency MedicineIL
-MO
Emergency MedicineIL
Emergency MedicineIL
Emergency MedicineIL

Reviews

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Frequently asked questions

Where can patients find MR. JACOB JONATHAN WHITE (PA)'s NPI?
You can confirm MR. JACOB JONATHAN WHITE (PA) with NPI 1265818884; it appears in the national provider directory.
Is MR. JACOB JONATHAN WHITE (PA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does MR. JACOB JONATHAN WHITE (PA) list a primary specialty?
If you are matching referrals, note Physician Assistant for MR. JACOB JONATHAN WHITE (PA). Clinical services aligned with this taxonomy classification.
Where does public data place MR. JACOB JONATHAN WHITE (PA)?
The snapshot lists Chicago, Illinois for MR. JACOB JONATHAN WHITE (PA); download NPPES for the complete set.
Is MR. JACOB JONATHAN WHITE (PA) a real provider?
This page reflects official NPPES data for NPI 1265818884. Always confirm identity and privileges with the practice and licensing boards.

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