Jincy Jacob

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

BP10032427 Issued in TX

Practice address

832 S Grevillea Ave
Inglewood, CA 90301-3312

Phone

(310) 419-4354

Fax

(310) 419-4621

NPI assigned

Jul 2, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jincy Jacob Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

JWCH Institute IncGroup PAC ID 1850394123, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jincy.jacob.p1@direct.lakeside.nextgenshare.com
• Direct secure messaging: jincy.jacobmd.p1@direct.jwch.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• JWCH Institute Inc

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1407808058
  Medicare reassignment Care Compare group NPD
• JWCH Institute Inc

  • Federally Qualified Health Center (FQHC)
  • Lancaster, CA
  • NPI 1073209177
  NPD

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1104088996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 S GREVILLEA AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903013312",
            "telephone_number": "310-419-4354",
            "fax_number": "310-419-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 S GREVILLEA AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903013312",
            "telephone_number": "310-419-4354",
            "fax_number": "310-419-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "JINCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10032427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JINCY",
            "last_name": "JACOB",
            "credential": "M.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Julie Iwuh
• J H Clinical Laboratory
• Jabir Rahman Sharif, M.D., Inc.
• Dionna Denee Jackson
• Francine M Jackson
• Julie Ann Jacob, MD
• Dahiana Jacobo
• Conor Jacobson, DDS
• Jamef Medical Supply
• James H Peace MD Inc

• Family Medicine Physician in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.