Individual provider Active NPI

Geetha Jacob, NP

  • Acute Care Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1356898381
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP131595 Issued in TX
Practice address
1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone
(817) 250-4906
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP131595 TX Primary

Addresses

Primary practice location

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122

Mailing address

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 250-4906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161021000196 MO Practitioner - Nurse Practitioner 2860770120 Reassigns benefits to 2 organizations
I20201021001750 TX Practitioner - Nurse Practitioner 2860770120 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

12505 Lebanon Rd
Suite 1442
Frisco, TX 75035-8298
Phone (972) 963-3550

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP131595TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Virtual Care CurrentSince Mar 1, 2024 Accepting new patients
Texas Health Physicians Group CurrentSince Sep 14, 2020 Accepting new patients
Texas Digestive Disease Consultants, PLLC CurrentSince Dec 1, 2022 Accepting new patients
Texas Health Physicians Group CurrentSince Sep 14, 2020 Accepting new patients
Healthtexas Provider Network CurrentSince Feb 24, 2025 Accepting new patients
Healthtexas Provider Network CurrentSince Feb 24, 2025 Accepting new patients
Southeastern Physician Services PC CurrentSince Oct 10, 2016 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Sound Physicians of Illinois, LLC CurrentSince Aug 1, 2017 Accepting new patients
Texas Digestive Disease Consultants, PLLC Current Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Texas Digestive Disease Consultants PLLC CurrentSince Dec 1, 2022 Accepting new patients
Texas Health Virtual Care CurrentSince Mar 1, 2024 Accepting new patients

Locations

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

8200 Walnut Hill Ln
Fl 9
Dallas, TX 75231
Phone (214) 345-8001

4370 Medical Arts Dr
Ste 295
Flower Mound, TX 75028
Phone (972) 691-3777

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

5425 W Spring Creek Pkwy
Ste 205
Plano, TX 75024
Phone (972) 526-5860

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Interoperability endpoints

  • Direct secure messaging: gjacob1372089@direct.sw.org
  • Direct secure messaging: gjacob1650752@direct.texashealth.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

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": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1356898381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042122",
            "telephone_number": "817-250-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042122",
            "telephone_number": "817-250-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "GEETHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP131595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.