NPIMap

Individual provider Active NPI

Ashley M Jacob, PA-C

  • Physician Assistant
  • Frisco, TX
National Provider Identifier
1194168856
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA08212 Issued in TX
Practice address
4461 Coit Rd
Suite 405
Frisco, TX 75035-0521
Phone
(972) 377-9200
Fax
(972) 377-9300
NPI assigned
Apr 12, 2013
Last updated
Apr 12, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA08212 TX Primary

Addresses

Primary practice location

4461 Coit Rd
Suite 405
Frisco, TX 75035-0521

Mailing address

4461 Coit Rd
Suite 405
Frisco, TX 75035-0521
Phone (972) 377-9200

Other identifiers 1

IdentifierTypeStateIssuer
PA08212OtherTXNCCPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130523000631 TX Practitioner - Physician Assistant 7315185790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mpower Clinical TXGroup PAC ID 1850716705, 31 clinicians

Practice addresses (Care Compare)

17101 Dallas Pkwy
Addison, TX 75001-7103
Phone (469) 248-3900

1800 Park Place Ave
Fort Worth, TX 76110-1302
Phone (682) 703-5600

2600 W Pleasant Run Rd
Crescent Medical Center at Lancaste
Lancaster, TX 75146-1114
Phone (972) 230-8888

3901 W 15TH St
Medical City Plano
Plano, TX 75075-7738
Phone (972) 596-6800

7 Trails End Rd
Abilene, TX 79602-5501
Phone (210) 598-2800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA08212TXMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1194168856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4461 COIT RD",
            "address_2": "SUITE 405",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750350521",
            "telephone_number": "972-377-9200",
            "fax_number": "972-377-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4461 COIT RD",
            "address_2": "SUITE 405",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750350521",
            "telephone_number": "972-377-9200",
            "fax_number": "972-377-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "ASHLEY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "PA08212",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.