Active NPI 1255446878 Individual Practitioner Male Practitioner

Jacob Lee Wonderlich , PA

Physician Assistant • Davenport, FL

Professional Overview & Biography Verified Profile Summary

Jacob Wonderlich, PA is a registered healthcare professional specializing in Physician Assistant in Davenport, FL. Practice services are available at 40100 HIGHWAY 27 under active NPI credentials.

Frequently performed procedures and clinical services include detection test by immunoassay with direct visual observation for influenza virus, established patient outpatient office visit, new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

40100 Highway 27

Davenport, FL 33837

Telephone 8634224971

Associated Practice Facility / Clinic

🏢 Emergency Physician Specialists Inc Facility NPI 1912973850

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Davenport, FL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 5.6 Yrs

State Avg: 11.1 Yrs

Regional Practice Density

26 Specialists

Practicing in Davenport, FL (10376 Statewide)

Telehealth Adoption Rate

11.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

77.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
87804 Detection test by immunoassay with direct visual observation for influenza virus	24	15	$72.41	$16.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
87804 Detection test by immunoassay with direct visual observation for influenza virus	32	16	$72.41	$16.25
99213 Established patient office or other outpatient visit, typically 15 minutes	21	21	$337.01	$77.42
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	17	17	$337.01	$96.24
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	15	$1200.00	$108.75
81003 Automated urinalysis test	13	13	$11.08	$2.21

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	70	65	$1970.66	$150.11
99284 Emergency department visit with moderate level of medical decision making	54	53	$1363.04	$101.79
99283 Emergency department visit with low level of medical decision making	38	37	$918.16	$53.65
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	16	16	$86.00	$7.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	90	88	$1966.00	$145.25
99284 Emergency department visit with moderate level of medical decision making	82	82	$1358.83	$99.71
99283 Emergency department visit with low level of medical decision making	74	72	$914.00	$52.51
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	28	27	$86.00	$7.10

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99283 Emergency department visit with low level of medical decision making	100	100	$909.60	$52.99
99285 Emergency department visit for life threatening or functioning severity	96	92	$1958.17	$149.74
99284 Emergency department visit with moderate level of medical decision making	66	65	$1352.09	$101.33
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	34	33	$85.03	$7.23

Medical Specialties & State Licenses

CMS Verified: 2021-07-07

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License FL PA9103414

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

292248700 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

29 Associated Practitioners

Dr. Jordan Martinez , MD

Emergency Medicine

NPI 1023639374

Doctor of Medicine (M.D.)

Dr. Tatjana Blazin , MD

Internal Medicine

NPI 1083359152

Doctor of Medicine (M.D.)

Kasey Acklin , CRNP

Nurse Practitioner

NPI 1114645132

Certified Registered Nurse Practitioner

Janet Garcia Garcia , RN

Registered Nurse - Registered Nurse First Assistant

NPI 1164308938

Registered Nurse

Dr. Robert Vergara , MD

Emergency Medicine

NPI 1174578710

Doctor of Medicine (M.D.)

Dr. Jerry Voit , MD

Emergency Medicine

NPI 1174781066

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 40100 HIGHWAY 27, DAVENPORT, FL 33837 (Tel: 8634224971)

📍

Updated Business Mailing Address July 08, 2007

Registered at 8390 CHAMPIONS GATE BOULEVARD, SUITE 306, CHAMPIONS GATE, FL 33896 (Tel: 4073901677)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as JACOB WONDERLICH, PA

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Physician Assistant (License #PA9103414 in FL)

🟢

Initial NPI Registration & Enumeration August 21, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1255446878

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 21, 2006

Last Update: July 07, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

8390 Champions Gate Boulevard, Suite 306

Champions Gate, FL 33896

Phone: 4073901677

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.