Edward R Jacobs OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EDWARD R JACOBS OD PC

Doing business as

Jacobs Eye Care

Practice address

999 Riverview Dr
Suite 203
Totowa, NJ 07512-1164

Phone

(973) 785-4499

Fax

(973) 785-4699

NPI assigned

Nov 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Edward R Jacobs, O.D. P.C.NPI 1134183726

Title

President

Phone

(973) 785-4499

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jacobs Eye Care Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward R Jacobs, OD

  • Optometrist
  • Totowa, NJ
  • NPI 1134183726
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1316127095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 RIVERVIEW DR",
            "address_2": "SUITE 203",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075121164",
            "telephone_number": "973-785-4499",
            "fax_number": "973-785-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 RIVERVIEW DR",
            "address_2": "SUITE 203",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075121164",
            "telephone_number": "973-785-4499",
            "fax_number": "973-785-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD R JACOBS OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-785-4499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D. P.C."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "098716",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacobs Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Totowa, NJ
• Providers in Totowa, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.