Jerry S Jacobs, O.D. PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1781TG Issued in TX

Practice address

400 S Zang Blvd
Ste 804
Dallas, TX 75208-6643

Phone

(214) 941-8923

Fax

(214) 941-4887

NPI assigned

Aug 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Txo 2 0 PLLC

  • Optometrist
  • Dallas, TX
  • NPI 1427675073
  NPD

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1407869340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S ZANG BLVD",
            "address_2": "STE 804",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752086643",
            "telephone_number": "214-941-8923",
            "fax_number": "214-941-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S ZANG BLVD",
            "address_2": "STE 804",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752086643",
            "telephone_number": "214-941-8923",
            "fax_number": "214-941-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JERRY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D. PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "1781TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00E22C",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron Benjamin Jacobs, NCC, LPC
• Beth A Jacobs, R. PH.
• Dale Travers Jacobs, D.D.S.
• Gary H Jacobs, CRNA
• Gary M. Jacobs, LPC
• Joanne Michelle Jacobs, CPNP
• Joe David Jacobs, D.M.D.,M.S.D.
• Kimberly Hewlett Jacobs
• Lana Jacobs, COTA
• Lindsay Jacobs, PHARMD

• Optometrist in Dallas, TX
• Providers in Dallas, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.