Jacob T. Dines, DO

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

License

OS17059 Issued in FL

Practice address

1 Administration Cir # Ms 1015
Ridgecrest, CA 93555-6104

Phone

(760) 939-8063

NPI assigned

Jan 22, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1003380288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ADMINISTRATION CIR # MS 1015",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935556104",
            "telephone_number": "760-939-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ADMINISTRATION CIR # MS 1015",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935556104",
            "telephone_number": "760-939-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINES",
        "first_name": "JACOB",
        "middle_name": "T.",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-22",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "FL",
            "license": "OS17059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracie Delgado
• Healthy Jayantilal Desai, M.D.
• Desert Bloom Inc.
• Desert Oasis Clinic
• Dianne Schindler Aud Inc
• Donald J. Dixon, M.D.
• Van Anh Ngoc Doan
• Savita Dongre, NP
• Alexis Dorais
• Kelly Ann Doty, PA

• All providers in Ridgecrest, CA
• Military Health Care Provider in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.