Jesu Jacob, D.O., P.C.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

235713 Issued in NY

Legal business name

JESU JACOB, D.O., P.C.

Practice address

66 Harned Rd
Commack, NY 11725-3527

Phone

(631) 670-7800

Fax

(631) 670-7798

NPI assigned

Aug 16, 2011

Organization subpart

No

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

Authorized official

Name

Jesu Jacob, D.O.NPI 1194990895

Title

Owner/ Ceo

Phone

(631) 670-7800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jesu Jacob, D.O.

  • Orthopaedic Surgery Physician
  • Commack, NY
  • NPI 1194990895
  Medicare reassignment NPD Authorized official
• Brian M Jones, RPA-C

  • Physician Assistant
  • Bay Shore, NY
  • NPI 1508156753
  Medicare reassignment NPD

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1457630899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 HARNED RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253527",
            "telephone_number": "631-670-7800",
            "fax_number": "631-670-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 HARNED RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253527",
            "telephone_number": "631-670-7800",
            "fax_number": "631-670-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESU JACOB, D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-16",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "JESU",
        "authorized_official_title_or_position": "OWNER/ CEO",
        "authorized_official_telephone_number": "631-670-7800",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "235713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jemi Charis James
• Jamie Epstein Speech Language Pathologist PC
• Christina Jamison, LMHC
• Janis Hoffman LCSW ,PLLC
• Stephanie Lynn Jaworowski, MSACN
• Patrick James Jewels, MSPT
• Devaraj Jeyamitra, M.D
• Gloria L. Johnsson, P.T.
• Jean Madinger Johnston, MD
• Linda Rachel Jonas, PHD

• Sports Medicine (Orthopaedic Surgery) Physician in Commack, NY
• Providers in Commack, NY by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.