Jason Chacko Jacob, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

051151 Issued in CT

Practice address

80 Seymour Street
Hartford Hospital Medicine Dept
Hartford, CT 06102-5037

Phone

(860) 545-2085

NPI assigned

Jul 28, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Internal Medicine

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hartford HospitalGroup PAC ID 2567366016, shared by 6 NPIs, 1,040 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hartford Hospital Hospital, Hartford, CT, CCN 070025

Merit-based Incentive Payment System (MIPS)

Final score

92.63 of 100Reported as group

Quality

75.35

Promoting interoperability

100

Improvement activities

40

Cost

71.44

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jason.jacob@xdr.hhchealthdirect.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.

• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216
  Medicare reassignment NPD
• Hartford Hospital

  • Surgery Physician
  • Hartford, CT
  • NPI 1407806391

  Internal Medicine

  Medicare reassignment NPD
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Medicare reassignment NPD
• Hartford Healthcare Medical Group Specialists LLC

  • Customized Equipment (DME)
  • Groton, CT
  • NPI 1295367068
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Care Compare affiliation
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1902834880
  Care Compare affiliation

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385337600000",
    "number": "1457582249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415933",
            "address_2": "HARTFORD HOSPITAL PROFESSIONAL SERVICES",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415933",
            "telephone_number": "860-545-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL MEDICINE DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-545-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "JASON",
        "middle_name": "CHACKO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-28",
        "last_updated": "2013-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "051151",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001511518",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Allen Jackson, PHARM.D.
• Seja Joyce Jackson, PHD, APRN, AAHIVS
• Tamara Jackson, LCSW
• Daisy Jacob, M.D.
• Dennis Peter Jacob, MD
• Mekha Jacob
• Rebecca Ariel Jacob, AUD
• Sandra Leo Jacob, LCSW
• Catherine Jacobs
• Kristina Rose Jacobs, M.A

• Internal Medicine Physician in Hartford, CT
• Providers in Hartford, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; 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.