Individual provider Active NPI

Salil G Jacob, MD

  • Pediatrics Physician
  • St Petersburg, FL
National Provider Identifier
1245256163
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME84815 Issued in FL
Practice address
1344 22ND St S
Saint Petersburg, FL 33712-2744
Phone
(727) 824-8181
NPI assigned
Jul 14, 2006
Last updated
Jun 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME84815 FL Primary

Addresses

Primary practice location

1344 22ND St S
Saint Petersburg, FL 33712-2744

Mailing address

1907 Tyrone Blvd N
St Petersburg, FL 33710-4841
Phone (727) 317-2117

Other practice location 1

1907 Tyrone Blvd N
St Petersburg, FL 33710-4841
Phone (727) 317-2117

Other identifiers 1

IdentifierTypeStateIssuer
264069400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20260527000845 FL Practitioner - Pediatric Medicine 0648740001

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14100 58TH St N
Clearwater, FL 33760-9900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME84815FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
All4Kidz Pediatrics, LLC Pediatrics CurrentSince Aug 2, 2020 Accepting new patients
Pediatric Health Care Alliance, PA Pediatrics PastSince Aug 28, 2021 Accepting new patients

Locations

1907 Tyrone Blvd N
St Petersburg, FL 33710
Phone (727) 317-2117

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.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1245256163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337104841",
            "telephone_number": "727-317-2117",
            "fax_number": "727-317-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 22ND ST S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337122744",
            "telephone_number": "727-824-8181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1907 Tyrone Blvd N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337104841",
            "country_code": "US",
            "telephone_number": "727-317-2117",
            "fax_number": "727-317-2104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SALIL",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME84815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264069400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.