NPIMap

Individual provider Active NPI

Moshir Jacob, MD

  • Internal Medicine Physician
  • Toledo, OH
National Provider Identifier
1245237007
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35070326 Issued in OH
Practice address
4235 Secor Rd
Toledo, OH 43623-4299
Phone
(419) 479-5728
Fax
(419) 479-5968
NPI assigned
Jul 7, 2005
Last updated
Mar 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35070326 OH Primary

Addresses

Primary practice location

4235 Secor Rd
Toledo, OH 43623-4299

Mailing address

4235 Secor Rd
Toledo, OH 43623-4299
Phone (419) 473-3561

Other identifiers 1

IdentifierTypeStateIssuer
2013547MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060105000458 OH Practitioner - Internal Medicine 3678557378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Toledo Clinic IncorporatedGroup PAC ID 5698673382, 204 clinicians

Practice addresses (Care Compare)

4235 Secor Rd
Toldeo, OH 43623-4231
Phone (419) 874-3246

4345 Secor Rd
Toledo, OH 43623-4233
Phone (419) 479-5777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35070326OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Clinic Incorporated Current Accepting new patients
Toledo Clinic Incorporated Internal Medicine CurrentSince Nov 3, 1999 Accepting new patients
Toledo Clinic Incorporated CurrentSince Nov 3, 1999 Accepting new patients
Mountain Crest Oh Opco LLC Past Accepting new patients
Regency Hospital of Toledo, LLC Past Accepting new patients
Toledo Clinic Incorporated Past Accepting new patients

Locations

5220 Alexis Rd
Sylvania, OH 43560
Phone (419) 318-5700

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

4235 Secor Rd
Bldg 1
Toledo, OH 43623
Phone (419) 479-5418

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJGJCA
  • Direct secure messaging: moshir.jacob@toledoclinic.eclinicaldirectplus.com

Organizations & group practices 6

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1245237007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234299",
            "telephone_number": "419-473-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234299",
            "telephone_number": "419-479-5728",
            "fax_number": "419-479-5968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "MOSHIR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35070326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2013547",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.