Jacob General Surgery, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

201551 Issued in LA

Legal business name

JACOB GENERAL SURGERY, LLC

Practice address

4228 Houma Blvd
Suite 220
Metairie, LA 70006-3000

Phone

(504) 264-9353

Fax

(504) 301-9312

NPI assigned

Nov 14, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ryan Andre Jacob, MDNPI 1942491394

Title

Owner

Phone

(504) 264-9353

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan Andre Jacob, M.D.

  • Surgery Physician
  • Metairie, LA
  • NPI 1942491394
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384387200000",
    "number": "1003246828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 HOUMA BLVD",
            "address_2": "SUITE 220",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700063000",
            "telephone_number": "504-264-9353",
            "fax_number": "504-301-9312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 HOUMA BLVD",
            "address_2": "SUITE 220",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700063000",
            "telephone_number": "504-264-9353",
            "fax_number": "504-301-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB GENERAL SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-14",
        "last_updated": "2013-11-14",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "ANDRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-264-9353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "LA",
            "license": "201551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508535",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toia Tiara Jackson
• Tremeisya Marche Jackson
• Walter Charles Jackson, DDS, MD
• Jacob Dent DDS Dentists of Metairie a Professional Corporation (Dentists of Metairie)
• Jacob Dent DDS. Metairie Modern Dentistry a Professional Corporation (Metairie Modern Dentistry)
• Jasmine Jacob
• Leah Gonsoulin Jacob, M.D.
• Rudolph Daniel Jacob, M.D.
• Ryan Andre Jacob, M.D.
• Jeanne Mireille Jacobi-Marino, LOTR

• Surgery Physician in Metairie, LA
• Providers in Metairie, LA by specialty
• Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.