Mort Jacobs Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00648000 Issued in NJ

Legal business name

MORT JACOBS INC

Doing business as

Mort Jacobs Pharmacy

Practice address

506 Park Ave
Paterson, NJ 07504-1532

Phone

(973) 279-4600

NPI assigned

Feb 1, 2007

Last updated

Feb 22, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bhavini Shah

Title

Pic

Phone

(973) 279-4600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mort Jacobs Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771718400000",
    "number": "1417095613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 PARK AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075041532",
            "telephone_number": "973-279-4600",
            "fax_number": "973-278-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 PARK AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075041532",
            "telephone_number": "973-279-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORT JACOBS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2026-02-22",
        "certification_date": "2026-02-22",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BHAVINI",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "973-279-4600"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00648000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069183",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mort Jacobs Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyle Andre Moore, PTA
• Kathleen Moran, RBT
• Shamaea Morgan
• Michael Anthony Mormile, RPH
• Jenna Morrone, DO
• Nicholas Mota, D.O.
• Sabin Bhagwan Motwani, M.D.
• Mohammed Amer Moughrabi, MD, DC
• Jonathan Edward Movsik
• Mpower Chiropractic Wellness Center LLC

• Community/Retail Pharmacy in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.