Individual provider Active NPI

Ronald Irving Jacoby, M.D.

  • Internal Medicine Physician
  • Cape Coral, FL
National Provider Identifier
1346269669
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME90603 Issued in FL
Practice address
1413 Viscaya Pkwy
Cape Coral, FL 33990-6206
Phone
(239) 458-5747
Fax
(239) 984-5365
NPI assigned
Jul 18, 2006
Last updated
Nov 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G20885 CA
Internal Medicine Physician 207R00000X ME90603 FL Primary
Physical Medicine & Rehabilitation Physician 208100000X ME90603 FL
General Practice Physician 208D00000X G20885 CA

Addresses

Primary practice location

1413 Viscaya Pkwy
Cape Coral, FL 33990-6206

Mailing address

706 Cote Azur Drive
Palm Beach Gardens, FL 33410
Phone (561) 223-3313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120320000140 FL Practitioner - Internal Medicine 5193985737 Reassigns benefits to 1 organization
I20150220000913 CA Practitioner - Internal Medicine 5193985737 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York Medical College, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cesca Medical Group IncGroup PAC ID 5193127728, 2 clinicians
SFS Medical Group, IncGroup PAC ID 5597158246, 3 clinicians

Practice addresses (Care Compare)

15424 Hawthorne Blvd
Suite 302
Lawndale, CA 90260-2175
Phone (424) 310-2707

8611 Crenshaw Blvd
Suite 210
Inglewood, CA 90305-3306
Phone (310) 910-8372

9140 S Nobel Way
Inglewood, CA 90305-1881

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G20885CAMDInternal Medicine Physician
ME90603FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yh Medical Group PC Internal Medicine Current Accepting new patients
Cape Coral Integrated Medical Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Cape Coral Integrated Medical Current Accepting new patients
SFS Medical Group, Inc CurrentSince Jan 25, 2023 Accepting new patients
Cesca Medical Group Inc CurrentSince Sep 25, 2021 Accepting new patients
Socorro Health LLC Internal Medicine Past Accepting new patients

Locations

8611 Crenshaw Blvd
Ste 210
Inglewood, CA 90305
Phone (310) 910-8372

15424 Hawthorne Blvd
Ste 302
Lawndale, CA 90260
Phone (424) 310-2707

1413 Viscaya Pkwy
Cape Coral, FL 33990
Phone (239) 242-0070

Interoperability endpoints

  • Direct secure messaging: ronald.jacoby.1@24825.direct.athenahealth.com
  • Direct secure messaging: sfsmedicalgroupinc.rolandjacoby@152378.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1346269669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 COTE AZUR DRIVE",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33410",
            "telephone_number": "561-223-3313",
            "fax_number": "561-223-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 VISCAYA PKWY",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339906206",
            "telephone_number": "239-458-5747",
            "fax_number": "239-984-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "RONALD",
        "middle_name": "IRVING",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G20885",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME90603",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME90603",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G20885",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.