Individual provider Active NPI

Jamie Ann Jacobs, PA-C

  • Surgical Physician Assistant
  • Ocala, FL
National Provider Identifier
1376635235
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9104522 Issued in FL
Practice address
1710 SE 16TH Ave
Ocala, FL 34471-4656
Phone
(352) 620-1900
Fax
(352) 620-1901
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1708 MA
Surgical Physician Assistant 363AS0400X PA9104522 FL Primary

Addresses

Primary practice location

1710 SE 16TH Ave
Ocala, FL 34471-4656

Mailing address

4500 W Newberry Rd
Gainesville, FL 32607-2245
Phone (352) 336-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040830000750 MA Practitioner - Physician Assistant 3375518707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

148 Chestnut St
Needham, MA 02492-2505
Phone (781) 983-9088

200 Boylston St
Chestnut Hill, MA 02467-2012
Phone (781) 983-9088

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

482 Bedford St
Lexington, MA 02420-1402
Phone (781) 983-9088

Hospital & facility affiliations

  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Beth Israel Deaconess Hospital - Needham Hospital, Needham, MA, CCN 220083
  • New England Baptist Hospital Hospital, Boston, MA, CCN 220088
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1708MAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jun 21, 2014 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 1, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jun 21, 2014 Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

1 University Ave
Westwood, MA 02090
Phone (617) 754-1021

Interoperability endpoints

  • Direct secure messaging: jjacobs254038@direct.bilh.masshiway.net

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1376635235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 W NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072245",
            "telephone_number": "352-336-6000",
            "fax_number": "352-332-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 SE 16TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714656",
            "telephone_number": "352-620-1900",
            "fax_number": "352-620-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JAMIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1708",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9104522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.