Physician Profile
Unclaimed ProfileAbout FORM
Jacob S. Form, D.P.M. is a healthcare provider in Lafayette Hill, PA specialising in podiatry. Jacob trained at Temple University School of Podiatric Medicine, graduating in 1980.
Summarised automatically from public NPI registry and CMS Medicare data. Not written or reviewed by this provider. Claim this profile to replace it.
Education & Training
Areas of Expertise
Common questions
What is Dr. Form's specialty?
Dr. Form is a podiatry in Lafayette Hill, PA. This is the primary taxonomy recorded against the NPI in the federal registry, listed there as “PODIATRY”.
NPI registry
Where can I find Dr. Form?
Dr. Form is listed at 4129 FRANKLIN WAY, Lafayette Hill, PA 19444. Addresses come from the NPI registry and can lag a move, so confirm before travelling.
NPI registry
How do I contact Dr. Form?
The number on file is (215) 292-2637. Guide.md cannot book appointments or pass on messages — please call the office directly.
NPI registry
What is Dr. Form's NPI number?
Dr. Form's National Provider Identifier is 1356367494. It is issued by the Centers for Medicare & Medicaid Services and is unique and permanent — it does not change if they move practice.
NPI registry
What is Dr. Form's medical education?
Dr. Form attended Temple University School of Podiatric Medicine, graduating in 1980. This comes from the CMS National Downloadable File.
CMS public data
How long has Dr. Form been practising?
Dr. Form has 46 years experience. Calculated from a graduation year of 1980, reported in the CMS National Downloadable File.
CMS public data
What is Dr. Form known for?
According to Medicare billing data, Dr. Form performs procedures including removal of fingernails or toenails, 6 or more nails, removal of fingernails or toenails, 1-5 nails and removal of noncancer thickened skin growth, 2-4 growths, alongside routine visits and testing. This reflects Medicare patients only and is billing volume, not a measure of quality.
Medicare claims
Has Dr. Form confirmed this information?
Not yet. This profile is built from public federal data and has not been confirmed by Dr. Form. If this is you, claiming it is free.
Guide.md
Licensing & Certification
Source: NPPES NPI Registry
Contact Information
- (215) 292-2637
- Email not available
Practice Locations
4129 FRANKLIN WAY
Lafayette Hill, PA 19444
Procedures Most Often Billed to Medicare
2,244 services · 828 patients · 9 distinct codes
| Procedure | Type | Code | Services |
|---|---|---|---|
| Removal of fingernails or toenails, 6 or more nails | Procedure | 11721 |
1,498 |
| Removal of fingernails or toenails, 1-5 nails | Procedure | 11720 |
233 |
| Removal of noncancer thickened skin growth, 2-4 growths | Procedure | 11056 |
117 |
| Removal of noncancer thickened skin growth, 1 growth | Procedure | 11055 |
100 |
| Removal of fingernails or toenails, 6 or more nails | Procedure | 11721 |
72 |
| Trimming of fingernails or toenails | Procedure | 11719 |
66 |
| Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | Office visit | 99308 |
101 |
| Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | Office visit | 99307 |
43 |
| Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | Office visit | 99308 |
14 |
Source: CMS Medicare public data. Shows how often procedures were billed — not quality of care or patient satisfaction.
Related providers
Connections drawn from the registry and from what providers have told us. A link here is not a referral or an endorsement.
Trained at Temple University School of Podiatric Medicine 8
Other providers in the same specialty who trained at the same institution.
Class of 1980 at Temple University School of Podiatric Medicine 8
Providers who graduated from the same medical school in the same year.
Also performs Removal of fingernails or toenails, 6 or more nails 8
Providers in PA who bill this service to Medicare most often.
Provider data sourced from the NPPES NPI Registry and CMS public datasets. Information is provided for reference and is not medical advice.