Marianne Jacob

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

297526 Issued in NY

Practice address

375 Mount Pleasant Ave
West Orange, NJ 07052-2750

Phone

(973) 322-6900

Fax

(973) 322-6999

NPI assigned

Aug 15, 2017

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

Medicare fee-for-service enrollment

Enrolled in NJ

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

Pediatric Medicine

Education

Lake Erie College of Osteopathic Medicine, Erie, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjacob124743@epicdirect.rwjbh.org

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.

• Barnabas Health Medical Group PC

  • Specialist
  • Elizabeth, NJ
  • NPI 1841557246
  Medicare reassignment Care Compare group NPD
• Barnabas Health Medical Group PC

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1316772668
  NPD

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1215453857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 SYCAMORE LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 MOUNT PLEASANT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522750",
            "telephone_number": "973-322-6900",
            "fax_number": "973-322-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "MARIANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2022-10-06",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NJ",
            "license": "25MB11494800",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "297526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Marie Iturbides, MS CCC-SLP
• Robert A Ivker, DO
• Corine Iwuala
• Joycelene Iwuala
• Jack Gold Surgical Appliances, Inc.
• Sonia Jacob
• Tess Jacob, M.D
• Fred Martin Jacobs, MD JD
• Jag Pediatric Therapy
• Jag-One Physical Therapy, LLC

• Pediatric Endocrinology Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Pediatric Endocrinology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.