Individual provider Active NPI

Aaron Lee Jacob, MD

  • General Practice Physician
  • Fort Leonard Wood, MO
National Provider Identifier
1275524274
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
40656 Issued in WI
Practice address
126 Missouri Ave
Glwach Attn: MCXP-CCS-CR
Fort Leonard Wood, MO 65473-8952
Phone
(573) 596-0417
Fax
(573) 596-0524
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 40656 WI Primary

Addresses

Primary practice location

126 Missouri Ave
Glwach Attn: MCXP-CCS-CR
Fort Leonard Wood, MO 65473-8952

Mailing address

126 Missouri Ave
Glwach Attn: MCXP-CCS-CR
Fort Leonard Wood, MO 65473-8952
Phone (573) 596-0417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20250218002677 WI Practitioner - Preventive Medicine 5395929517 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40656WIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA Current Accepting new patients
American Current Care P.a. CurrentSince Feb 10, 2025 Accepting new patients
American Current Care PA CurrentSince Feb 10, 2025 Accepting new patients
American Current Care P.a. Current Accepting new patients

Locations

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

2455 N 124th St
Brookfield, WI 53005
Phone (262) 782-9326

358 Junction Rd
Madison, WI 53717
Phone (608) 829-1888

215 N 35th St
Milwaukee, WI 53208
Phone (414) 931-7600

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1275524274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 MISSOURI AVE",
            "address_2": "GLWACH ATTN: MCXP-CCS-CR",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654738952",
            "telephone_number": "573-596-0417",
            "fax_number": "573-596-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 MISSOURI AVE",
            "address_2": "GLWACH ATTN: MCXP-CCS-CR",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654738952",
            "telephone_number": "573-596-0417",
            "fax_number": "573-596-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "AARON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WI",
            "license": "40656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Leonard Wood, MO

Sources for this page

Verify at the official NPI Registry.