Jacob H Jacoby, MD PHD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

46259 Issued in NJ

Practice address

654 Ave C
Suite 201
Bayonne, NJ 07002

Phone

(201) 339-0323

Fax

(201) 339-0349

NPI assigned

Mar 20, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 30, 2025 through Dec 30, 2027

Specialty

Psychiatry

Education

State University of New York at Buffalo School of Medicine, 1980

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.jacoby@direct.bayonnemedicalcenter.md

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.

• Jacob Jacoby MD

  • Multi-Specialty Clinic/Center
  • Suffern, NY
  • NPI 1790347243
  NPD Authorized official
• Ijkg Opco LLC

  • Skilled Nursing Facility
  • Bayonne, NJ
  • NPI 1437356755
  NPD
• Advanced Surgical Group Inc.

  • Surgery Physician
  • East Brunswick, NJ
  • NPI 1306141221
  NPD (past)
• Paul Hriso MD PA

  • Psychiatry Physician
  • Bayonne, NJ
  • NPI 1649285594
  NPD (past)
• Shan Nagendra,M.D.P.C.

  • Specialist
  • Bayonne, NJ
  • NPI 1174705776
  NPD (past)
• Tri County Foot & Ankle Center LLC

  • Durable Medical Equipment & Medical Supplies
  • Bayonne, NJ
  • NPI 1962683235
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1174648232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 AVE C",
            "address_2": "SUITE 201",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "201-339-0323",
            "fax_number": "201-339-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 AVE C",
            "address_2": "SUITE 201",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "201-339-0323",
            "fax_number": "201-339-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "JACOB",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NJ",
            "license": "46259",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NY",
            "license": "156653-1",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "46259",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "156653-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "088BV1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pooja V Janani, DO

• Psychiatry Physician in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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; Opt Out Affidavits.
• 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.