Individual provider Active NPI

Linju Jacob

  • Family Nurse Practitioner
  • Richboro, PA
National Provider Identifier
1326536640
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP018669 Issued in PA
Practice address
1034 2ND Street Pike
Richboro, PA 18954-1863
Phone
(866) 389-2727
NPI assigned
Apr 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP018669 PA Primary

Addresses

Primary practice location

1034 2ND Street Pike
Richboro, PA 18954-1863

Mailing address

1034 2ND Street Pike
Richboro, PA 18954-1863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20180816002814 PA Practitioner - Nurse Practitioner 6103175641 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP018669PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Pennsylvania LLC Family CurrentSince Jul 23, 2018 Accepting new patients

Locations

1218 E Lancaster Ave
Bryn Mawr, PA 19010
Phone (610) 519-1920

840 S Valley Forge Rd
Lansdale, PA 19446
Phone (215) 362-6303

1034 2nd Street Pike
Richboro, PA 18954
Phone (215) 322-4060

Organizations & group practices 1

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": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1326536640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 2ND STREET PIKE",
            "city": "RICHBORO",
            "state": "PA",
            "postal_code": "189541863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 2ND STREET PIKE",
            "city": "RICHBORO",
            "state": "PA",
            "postal_code": "189541863",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "LINJU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richboro, PA

Sources for this page

Verify at the official NPI Registry.