Individual provider Active NPI

Karim Christopher Jacob, MD

  • Internal Medicine Physician
  • Toledo, OH
National Provider Identifier
1306309372
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
61268961 Issued in WA
Practice address
2213 Cherry St
Toledo, OH 43608-2603
Phone
(419) 251-3232
NPI assigned
Apr 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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 61268961 WA Primary

Addresses

Primary practice location

2213 Cherry St
Toledo, OH 43608-2603

Mailing address

9329 Tranquil Breeze LN
Sylvania, OH 43560-9837
Phone (419) 320-1727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220916000396 WA Practitioner - Internal Medicine 0143605840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone (206) 244-9970

202 N Division St
Auburn, WA 98001-4939
Phone (253) 833-7711

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61268961WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients
South Sound Inpatient Physicians, PLLC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Cogent Healthcare of Washington, PC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Multicare Health System Past Accepting new patients
Multicare Health System Past Accepting new patients

Locations

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1306309372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9329 TRANQUIL BREEZE LN",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435609837",
            "telephone_number": "419-320-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "419-251-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "KARIM",
        "middle_name": "CHRISTOPHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "61268961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.