Liji Jacob John, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

V3025 Issued in TX

Practice address

2704 N Galloway Ave Ste 103
Mesquite, TX 75150-6379

Phone

(214) 660-2500

NPI assigned

Mar 29, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Liji Jacob Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dallas Medical Physician GroupGroup PAC ID 7517194491, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Dallas Medical Physician Group

  • Cardiovascular Disease Physician
  • Dallas, TX
  • NPI 1033551312

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Dallas Medical Physician Group

  • Internal Medicine Physician
  • Plano, TX
  • NPI 1861802902

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1194303594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 N GALLOWAY AVE STE 103",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506379",
            "telephone_number": "214-660-2500",
            "fax_number": "833-535-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 N GALLOWAY AVE STE 103",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506379",
            "telephone_number": "214-660-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3201 Springhill Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "North Little Rock",
            "state": "AR",
            "postal_code": "721172909",
            "country_code": "US",
            "telephone_number": "501-753-4132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHN",
        "first_name": "LIJI",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V3025",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIJI",
            "last_name": "JACOB",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• JL Wellness Pharmacy, LLC
• Jobifa Group Inc.
• John a. Ozo
• John H. Fain, OD, PA
• Feni Stanley John, RN-FNP, AGACNP
• Sarah Joseph John, O.D.
• Sneha John, PHARMD
• William Johnson Jr
• Nkechi Johnson-Nwoke
• Ashley Nicole Johnson

• Family Medicine Physician in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.