NPIMap

Organization Active NPI

Pulmonary & Critical Care Specialists Inc

  • Critical Care Medicine (Internal Medicine) Physician
  • Maumee, OH
National Provider Identifier
1417428574
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
Legal business name
PULMONARY & CRITICAL CARE SPECIALISTS INC
Practice address
1661 Holland Rd Ste 100
Maumee, OH 43537-4206
Phone
(419) 377-6080
NPI assigned
Dec 16, 2018
Last updated
Feb 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Authorized official

Name
Dr. Hany Joseph Jacob, MDNPI 1992786677
Title
Owner/Ceo
Phone
(419) 377-6080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X Primary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X

Addresses

Primary practice location

1661 Holland Rd Ste 100
Maumee, OH 43537-4206

Mailing address

1661 Holland Rd Ste 100
Maumee, OH 43537-4206
Phone (419) 343-5016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190227002748 OH Part B Supplier - Clinic/Group Practice 0840539342 Receives reassigned benefits from 6 practitioners
Practice locations: Maumee, OH

National Provider Directory

National Provider Directory

Locations

1661 Holland Rd
Ste 100
Maumee, OH 43537
Phone (419) 794-1105

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1417428574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 HOLLAND RD STE 100",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435374206",
            "telephone_number": "419-343-5016",
            "fax_number": "419-794-1328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 HOLLAND RD STE 100",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435374206",
            "telephone_number": "419-377-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULMONARY & CRITICAL CARE SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "HANY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "419-377-6080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.