DR. JASON THOMAS ACKRIVO (MD) – Pulmonary Disease Physician, NPI 1003115395

DR. JASON THOMAS ACKRIVO (MD) is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in PULMONARY DISEASE. They hold the professional credentials MD. They hold a License No. MD458117 (PA). The NPI Number for DR. JASON THOMAS ACKRIVO (MD) is 1003115395

Main info

Male
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
DR. JASON THOMAS ACKRIVO (MD)
NPI
1003115395
Phone
(215) 614-0871
Address
3400 SPRUCE ST
Enumeration Date
25 March 2011
Last Update Date
5 November 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2156623202
Graduation Year
2011 (15 years ago)
PAC ID
8426280389
Group Practice PAC ID
6204730955
Professional Enrollment ID
I20181129000033
Address ID
PA191044229PH3400XSTXX313
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

1,086 PULMONARY DISEASE in PA

Provider Addresses for DR. JASON THOMAS ACKRIVO (MD)

  • 3400 SPRUCE ST

    PHILADELPHIA, PA 191044230

    Phone: (215) 614-0871

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $24.

Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.

Last reported payment date: 2024-05-21 • Largest payer in this snapshot: Baxter Healthcare ($24).

Total Amount

$24

General + Research + Ownership

Payments

1

Total payment records

General Amount

$24

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-21

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Baxter Healthcare$24
View all Open Payments →|Open Payments Risk Radar →

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: 2018-11-29

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
I20181129000033IPulmonary DiseasePATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes11124$0
99215Established patient office or other outpatient visit, 40-54 minutes7844$0
G2212Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or5927$0
99205New patient office or other outpatient visit, 60-74 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 19104)

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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: 6204730955View full group profile
NameSpecialtyState
-PA
Critical Care (Intensivists), Internal Medicine, Pulmonary DiseasePA
Nurse PractitionerPA
-PA
-PA
Emergency MedicinePA
Nurse PractitionerPA
O B S T E T R I C S/ G Y N E C O L O G YPA
Nurse PractitionerPA
-PA

Reviews

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Frequently asked questions

What identifier follows DR. JASON THOMAS ACKRIVO (MD) across health systems?
The NPI 1003115395 uniquely identifies DR. JASON THOMAS ACKRIVO (MD) in U.S. healthcare data.
Quick check: is DR. JASON THOMAS ACKRIVO (MD) active?
Public NPPES data shows DR. JASON THOMAS ACKRIVO (MD) with an active NPI status right now.
How should patients interpret DR. JASON THOMAS ACKRIVO (MD)'s specialty?
The extract shows Pulmonary Disease Physician for DR. JASON THOMAS ACKRIVO (MD). Clinical services aligned with this taxonomy classification.
Is DR. JASON THOMAS ACKRIVO (MD) tied to Philadelphia, Pennsylvania?
If you are local to Philadelphia, Pennsylvania, DR. JASON THOMAS ACKRIVO (MD) may be relevant to your search.
Who maintains DR. JASON THOMAS ACKRIVO (MD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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