Julianne Susan Jacob, MS,PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9578 Issued in GA

Practice address

225 Williamson St
Elizabeth, NJ 07202-3625

Phone

(973) 563-8430

NPI assigned

Jun 19, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcherian21285@direct.emory.org

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.

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment NPD
• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1407340987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 N 10TH ST",
            "city": "PROSPECT PARK",
            "state": "NJ",
            "postal_code": "075082214",
            "telephone_number": "973-563-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 WILLIAMSON ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023625",
            "telephone_number": "973-563-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "JULIANNE",
        "middle_name": "SUSAN",
        "credential": "MS,PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9578",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00473800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Easha Iyer, DMD
• Preeti Iyer, D.D.S.
• Shankar Iyer, DDS MDS
• J.M. Arrunategui, M.D., P.C.
• Tiera S Jackman
• Peter Jacob, LSW
• Elisa Jacobson, LCSW
• Lisa M. Jacobson, D.M.D.
• Syed Jaffry, MD
• Sharon D Jakes, LCSW

• Physician Assistant in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.