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PROVIDER PROFILE · NPI 1356367494

Jacob FormD.P.M.

PodiatryLafayette Hill, PAI
CROSS-REFERENCE

Related data on other Healthparse brands

ProviderScore
OIG/SAM exclusion screening, sanctions history
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QUALITY · MIPS · 2024
Final MIPS score
94.1
Quality
73.8
Cost
0.0
Improvement activities
40.0
Promoting interop.
95.0
Payment adjustment
0.80%
Group
PRESCRIBING · PART D · 2024
No data available for this provider in 2024.
INDUSTRY PAYMENTS · OPEN PAYMENTS · 2024
No data available for this provider in 2024.
MEDICARE UTILIZATION · PART B · 2024
Total beneficiaries
828
Unique beneficiaries
—
Total services
2,244
Distinct HCPCS
7
Medicare payment
$81K
Peer benchmark
Q1
Q2
Q3
Q4
Q5
Total Medicare services vs. 940 Podiatry providers in PA — above median (cohort median 1,734).
REFERRAL NETWORK

Where Jacob Form's patients come from & go

Directional shared-patient flow from Medicare claims — who sends patients to this provider (inbound) and where this provider's patients go next (outbound). 84 inbound referrers · 146 outbound destinations.

Receives referrals from
Inbound — who sends patients here
PhysicianPatientsVisits
Aculabs Inc
Clinical Laboratory · East Brunswick, NJ
3661,331
Steven Lewis
Family Practice · Narberth, PA
118361
CLIVEDEN NURSING AND REHABILITATION CENTER PA, LP97194
WOODRING, ALBERT94124
Joann Stracuzzi
Nurse Practitioner · Feasterville Trevose, PA
85223
KHAN, AZAD78222
Elizabeth Bradley
Family Practice · Penn Valley, PA
77145
Quest Diagnostics Clinical Laboratories Inc
Clinical Laboratory · Norristown, PA
73153
Physician's Mobile X-Ray, Inc.
Portable X-Ray Supplier · Harrisburg, PA
6373
U S LAB & RADIOLOGY LLC59244
Amy Clouse
Family Practice · Jenkintown, PA
57177
Gerald Hansen
Family Practice · Jenkintown, PA
56187
Refers patients to
Outbound — where patients go next
PhysicianPatientsVisits
Aculabs Inc
Clinical Laboratory · East Brunswick, NJ
3431,256
CARE PAVILION NURSING AND REHABILITATION CENTER PA LP178420
Symphony Diagnostic Services No 1 Llc
Portable X-Ray Supplier · Sparks, MD
145218
Jerry Cohen
General Practice · Narberth, PA
144498
Adam Sobel
Internal Medicine · Wynnewood, PA
129653
Keystone Quality Transport Company
Ambulance Service Provider · Springfield, PA
124218
Larry Durlofsky
Geriatric Psychiatry · Bala Cynwyd, PA
119161
WOODRING, ALBERT113165
Steven Lewis
Family Practice · Narberth, PA
111370
ABINGTON MEMORIAL HOSPITAL90341
CLIVEDEN NURSING AND REHABILITATION CENTER PA, LP89177
ALBERT EINSTEIN MEDICAL CENTER88138
Source: CMS Physician Shared Patient Patterns (30-day window, Medicare FFS). Direction = a beneficiary seen by the first provider, then the second, within 30 days; a proxy for referral, not a documented referral. Pairs with fewer than 11 shared beneficiaries are suppressed.