Sophiamma A Jacob, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00527100 Issued in NJ

Practice address

26 Throckmorton LN
Old Bridge, NJ 08857-2520

Phone

(732) 679-9950

Fax

(732) 679-9956

NPI assigned

Jan 21, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/
• Direct secure messaging: sophiamma.jacob@direct.hackensackmeridian.org

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.

• Hackensack Meridian Health Medical Group - Primary Care PC

  • Family Medicine Physician
  • Red Bank, NJ
  • NPI 1336203538
  Medicare reassignment NPD
• Meridian Medical Group - Specialty Care, PC

  • Family Medicine Physician
  • Edgewater, NJ
  • NPI 1275362105
  NPD (past)

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1326437856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GOSHAWK CT",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077511073",
            "telephone_number": "732-591-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 THROCKMORTON LN",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572520",
            "telephone_number": "732-679-9950",
            "fax_number": "732-679-9956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SOPHIAMMA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00527100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene A Isola III, DDS
• Frank Anthony Isola, DMD
• Ludmila Ivchenko, MD
• Sathish Iyer, D.D.S
• Rincy Jacob
• John Hubert Jaeger, D.C.
• Jafri Behavioral Health
• Rana Jafri, MD
• Nikhil K Jain, M.D.
• Namrata Jani, NP-C

• Adult Health Nurse Practitioner in Old Bridge, NJ
• Providers in Old Bridge, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.