Individual provider Active NPI

Nomy Thomas Jacob, DNP,CRNP,SCRN,CNRN

  • Adult Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1265046742
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R178758 Issued in MD
Practice address
2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone
(443) 374-8926
NPI assigned
Sep 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R178758 MD Primary

Addresses

Primary practice location

2401 W Belvedere Ave
Baltimore, MD 21215-5216

Mailing address

2401 W Belvedere Ave
Baltimore, MD 21215-5216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210302000252 MD Practitioner - Nurse Practitioner 5496161358 Reassigns benefits to 1 organization
I20210707000276 DC Practitioner - Nurse Practitioner 5496161358 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

3007 Tilden St NW
Suite 5N
Washington, DC 20008-3030

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baltimore Suburban Health, LLC CurrentSince Jan 1, 2021 Accepting new patients
Medstar Medical Group II LLC CurrentSince Oct 13, 2021 Accepting new patients
Medstar Total Elder Care LLC CurrentSince Jul 1, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

110 Irving St NW
Rm 3114
Washington, DC 20010
Phone (202) 877-0570

2401 W Belvedere Ave
Baltimore, MD 21215

18101 Prince Philip Dr
Olney, MD 20832
Phone (301) 774-8618

10085 Red Run Blvd
Ste 306
Owings Mills, MD 21117
Phone (410) 581-7804

4000 Old Court Rd
Ste 301
Pikesville, MD 21208
Phone (410) 496-7700

18100 Slade School Rd
Sandy Spring, MD 20860
Phone (301) 223-7971

18131 Slade School Rd
Sandy Spring, MD 20860
Phone (301) 260-1075

2000 15th St N
Ste 600
Arlington, VA 22201
Phone (202) 425-0000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14466/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1265046742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "443-374-8926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS JACOB",
        "first_name": "NOMY",
        "name_prefix": "Dr.",
        "credential": "DNP,CRNP,SCRN,CNRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R178758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.