Bradley G Jacoby, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

027835 Issued in GA

Practice address

7170 Highway 278
Ste B
Covington, GA 30014

Phone

(770) 787-6200

Fax

(770) 787-2643

NPI assigned

Oct 19, 2006

Last updated

Aug 2, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Ophthalmology

Education

Vanderbilt University School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bgjacoby@premierop.direct.eyemdemr.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Piedmont Newton Hospital, Inc.

  dba Newton Medical Center

  • General Acute Care Hospital
  • Covington, GA
  • NPI 1760498588

  Corporate Director

  CMS ownership

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

• Premier Ophthalmology LLC

  • Ophthalmology Physician
  • Covington, GA
  • NPI 1427261759
  Medicare reassignment NPD Authorized official
• Premier Ophthalmology, LLC

  • Eyewear Supplier
  • Covington, GA
  • NPI 1548315252

  Ophthalmology

  NPD Authorized official
• Atlanta Retina PC

  • Ophthalmology Physician
  • Atlanta, GA
  • NPI 1669652673
  NPD (past)

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

• Piedmont Newton Hospital, Inc.

  dba Newton Medical Center

  • General Acute Care Hospital
  • Covington, GA
  • NPI 1760498588
  Care Compare affiliation

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1174605372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7170 HIGHWAY 278",
            "address_2": "SUITE B",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "30014",
            "telephone_number": "770-787-6200",
            "fax_number": "770-787-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7170 HIGHWAY 278",
            "address_2": "STE B",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "30014",
            "telephone_number": "770-787-6200",
            "fax_number": "770-787-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "BRADLEY",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "027835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000326697B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly D. Jackson, M.S., CCC-SLP
• Vagillia Faye Jackson, LMSW
• Veronica S Jackson, FNP
• William Marc Jackson, DC
• Jacob's Well Medical Center
• Jakai Enterprise LLC
• James D Barber OD LLC
• Courtney Lynn Rose James, MS, GA, NY
• Kenyona James
• Frank Jarman III, MA

• Ophthalmology Physician in Covington, GA
• Providers in Covington, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.