Individual provider Active NPI

Besty Jacob, O.D.

  • Optometrist
  • Coral Springs, FL
National Provider Identifier
1336572643
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4800 Issued in FL
Practice address
4621 Coral Ridge Dr
Coral Springs, FL 33076-2200
Phone
(954) 715-8253
NPI assigned
Aug 11, 2013
Last updated
Oct 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4800 FL Primary

Addresses

Primary practice location

4621 Coral Ridge Dr
Coral Springs, FL 33076-2200

Mailing address

829 SW 9TH Ter
Ft Lauderdale, FL 33315-1125
Phone (954) 554-9331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220225000427 FL Practitioner - Optometry 5395139083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4800FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel J Teske OD PA Optometrist PastSince Jan 26, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1376179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1336572643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 SW 9TH TER",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333151125",
            "telephone_number": "954-554-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 CORAL RIDGE DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330762200",
            "telephone_number": "954-715-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "BESTY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-11",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.