Individual provider Active NPI

Tikva Jacobs, MD

  • Vascular Surgery Physician
  • New York, NY
National Provider Identifier
1396711040
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
214917 Issued in NY
Practice address
520 E 70TH St FL 8
New York, NY 10021-9800
Phone
(646) 962-8450
Fax
(646) 962-0323
NPI assigned
Feb 23, 2006
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 214917 NY Primary
Surgery Physician 208600000X 214917 NY

Addresses

Primary practice location

520 E 70TH St FL 8
New York, NY 10021-9800

Mailing address

520 E 70TH St FL 8
New York, NY 10021-9800
Phone (646) 962-8450

Other identifiers 1

IdentifierTypeStateIssuer
02647923MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050608001184 NY Practitioner - Vascular SurgeryPractitioner - General Surgery 4981647013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
George Washington University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

525 E 68TH St
New York, NY 10065-4870
Phone (212) 746-5454

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal66

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214917NYMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Oct 16, 2017 Accepting new patients
Weill Medical College of Cornell Surgery CurrentSince Oct 16, 2017 Accepting new patients
Weill Cornell University Medical College Past Accepting new patients
North General Physician Services PLLC Surgery PastSince Jul 1, 2006 Accepting new patients
Park Lenox Surgical, PC Vascular Surgery PastSince Aug 23, 2009 Accepting new patients

Locations

50 E 69th St
New York, NY 10021
Phone (212) 570-4000

520 E 70th St
Fl 8
New York, NY 10021
Phone (646) 962-2270

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: tij9024@direct.nyp.org

Organizations & group practices 5

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1396711040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 70TH ST FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100219800",
            "telephone_number": "646-962-8450",
            "fax_number": "646-962-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E 70TH ST FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100219800",
            "telephone_number": "646-962-8450",
            "fax_number": "646-962-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "TIKVA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "214917",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "214917",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02647923",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.