Individual provider Active NPI

Nidhi Susanna Jacob, M.D.

  • Obstetrics & Gynecology Physician
  • San Jose, CA
National Provider Identifier
1154611762
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A 116501 Issued in CA
Practice address
2400 Samaritan Dr
Suite 105/Suite 203
San Jose, CA 95124-3910
Phone
(408) 523-3870
NPI assigned
Apr 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A 116501 CA Primary

Addresses

Primary practice location

2400 Samaritan Dr
Suite 105/Suite 203
San Jose, CA 95124-3910

Mailing address

2350 W. El Camino Real
2ND Floor
Mountain View, CA 94040-6203

Other names 1

  • Nidhi Jacob Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20131112000365 CA Practitioner - Obstetrics/Gynecology 0042446585 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, shared by 16 NPIs, 3,783 clinicians

Practice addresses (Care Compare)

2425 Samaritan Dr
San Jose, CA 95124-3908
Phone (408) 559-2011

2506 Samaritan CT
San Jose, CA 95124-4001
Phone (408) 739-6000

370 Distel Cir
Los Altos, CA 94022-1404
Phone (650) 254-5200

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

Hospital & facility affiliations

  • Good Samaritan Hospital Hospital, San Jose, CA, CCN 050380

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A 116501CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Mar 19, 2024 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Sep 30, 2013 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Sep 30, 2013 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Oct 21, 2014 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Sep 30, 2013 Accepting new patients
Sutter East Bay Medical Foundation Obstetrics & Gynecology Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

701 E El Camino Real
#1
Mountain View, CA 94040
Phone (650) 404-8440

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

795 El Camino Real
#1112
Palo Alto, CA 94301

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

2581 Samaritan Dr
Ste 308
San Jose, CA 95124
Phone (408) 355-1700

2400 Samaritan Dr
Ste 105
San Jose, CA 95124
Phone (408) 523-3870

2506 Samaritan Ct
San Jose, CA 95124
Phone (408) 523-3870

2400 Samaritan Dr
Ste 203
San Jose, CA 95124
Phone (408) 369-5600

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: njacob188370@hisp.ehr.sutterhealth.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1154611762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W. EL CAMINO REAL",
            "address_2": "2ND FLOOR",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 SAMARITAN DR",
            "address_2": "SUITE 105/SUITE 203",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243910",
            "telephone_number": "408-523-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "NIDHI",
        "middle_name": "SUSANNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-15",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A 116501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIDHI",
            "last_name": "JACOB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.