Individual provider Active NPI

Jacob Hayes, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Lubbock, TX
National Provider Identifier
1104271956
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
T5123 Issued in TX
Practice address
4015 22ND St
Lubbock, TX 79410-1115
Phone
(806) 725-0030
Fax
(806) 725-0015
NPI assigned
Apr 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 2019010646 MO
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X T5123 TX Primary

Addresses

Primary practice location

4015 22ND St
Lubbock, TX 79410-1115

Mailing address

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 577-5634

Other practice location 1

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 577-5634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20220713001640 TX Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 2860784998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Emergency Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians Emergency Medicine of Texas PLLCGroup PAC ID 9739449802, 112 clinicians

Practice addresses (Care Compare)

4002 24TH St
Lubbock, TX 79410-1894
Phone (806) 725-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T5123TXMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of Texas PLLC CurrentSince Feb 1, 2025 Accepting new patients
Texas Tech University Health Sciences Center Lubbock PastSince Jul 17, 2022 Accepting new patients

Locations

1275 Marvin Hancock Dr
Jasper, TX 75951
Phone (409) 384-1951

4002 24th St
Lubbock, TX 79410
Phone (806) 300-3229

3600 Gates Blvd
Port Arthur, TX 77642
Phone (409) 985-7431

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1104271956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5634",
            "fax_number": "314-577-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 22ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101115",
            "telephone_number": "806-725-0030",
            "fax_number": "806-725-0015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1465 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041003",
            "country_code": "US",
            "telephone_number": "314-577-5634",
            "fax_number": "314-577-5616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYES",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MO",
            "license": "2019010646",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "T5123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.