Active NPI
Ilias Jacob
- Rehabilitation Practitioner
- San Jose, CA
National Provider Identifier
1376220475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 438 N White Rd
San Jose, CA 95127-1439 - Phone
- (408) 254-6828
- NPI assigned
- Jun 29, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary | ||
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
438 N White Rd
San Jose, CA 95127-1439
Mailing address
1922 The Alameda Ste 316
San Jose, CA 95126-1461
Phone (408) 261-7777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751500800000",
"number": "1376220475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1922 THE ALAMEDA STE 316",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951261461",
"telephone_number": "408-261-7777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "438 N WHITE RD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951271439",
"telephone_number": "408-254-6828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "ILIAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-29",
"last_updated": "2025-07-03",
"certification_date": "2025-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.