Wendy Lynn Jacobs, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY6367 Issued in FL

Practice address

2650 Bahia Vista St Ste 201
Sarasota, FL 34239-2625

Phone

(941) 402-7520

NPI assigned

Aug 30, 2006

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 identifiers 6

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Wendy Jacobs, JD, PHD, PA

  • Clinical Psychologist
  • Sarasota, FL
  • NPI 1447520010
  Medicare reassignment NPD Authorized official
• Assessment and Psychotherapy Services, Inc

  • Clinical Psychologist
  • Sarasota, FL
  • NPI 1437428273
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1174633242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17263",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342760263",
            "telephone_number": "941-402-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 BAHIA VISTA ST STE 201",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392625",
            "telephone_number": "941-402-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "WENDY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPHEALTH",
            "identifier": "01-0698740",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEECHSTREET",
            "identifier": "1353547",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2068388",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "275688",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "01-0698740",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/MAGELLUM",
            "identifier": "276480-000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Jacob, MD
• Benjamin Jacobi, MD
• Christian Jacobs
• Olivia Grace Jacobs, DO
• Thomas Q. Jacobs, D.C.
• Danielle Marie Jacobson, PT
• Jacque Ruch, LLC
• Jacqueline a. Bik, M.D., PA
• Tracy R. Jaekel, ED.D.
• Caitlin Jagoda, CCC-SLP

• Psychologist in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.