Individual provider Active NPI

Jade Mas Koba, M.D.

  • Obstetrics & Gynecology Physician
  • Cape Coral, FL
National Provider Identifier
1457738064
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME171297 Issued in FL
Practice address
650 Del Prado Blvd S Ste 100
Cape Coral, FL 33990-5617
Phone
(239) 424-2060
Fax
(239) 424-2061
NPI assigned
May 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A162053 CA
Obstetrics & Gynecology Physician 207V00000X ME171297 FL Primary

Addresses

Primary practice location

650 Del Prado Blvd S Ste 100
Cape Coral, FL 33990-5617

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 424-2060

Other practice location 1

30 Shelburne Road
Stamford, CT 06902
Phone (203) 276-7581

Other practice location 2

30 Shelburne Road
Stamford, CT 06902
Phone (203) 276-7581

Other practice location 3

220 S Palisade Dr Ste 203
Santa Maria, CA 93454
Phone (805) 354-7101

Other practice location 4

210 S Palisade Dr Ste 101
Santa Maria, CA 93454-5932
Phone (805) 922-0481

Other identifiers 1

IdentifierTypeStateIssuer
125173600MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmaskoba470946@Direct.leememorial.org Direct LEE HEALTH SYSTEM INC

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250109001422 FL Practitioner - Obstetrics/Gynecology 1153656657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Florida International Univ, College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

650 Del Prado Blvd S
Suite 100
Cape Coral, FL 33990-5617
Phone (239) 424-2060

Hospital & facility affiliations

  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A162053CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc Obstetrics & Gynecology CurrentSince Feb 1, 2025 Accepting new patients
Lee Health System Inc CurrentSince Feb 1, 2025 Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

650 Del Prado Blvd S
Ste 100
Cape Coral, FL 33990
Phone (239) 424-2060

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jmaskoba470946@direct.leememorial.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1457738064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-424-2060",
            "fax_number": "239-424-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 DEL PRADO BLVD S STE 100",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339905617",
            "telephone_number": "239-424-2060",
            "fax_number": "239-424-2061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Shelburne Road",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "06902",
            "country_code": "US",
            "telephone_number": "203-276-7581",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 Shelburne Road",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "06902",
            "country_code": "US",
            "telephone_number": "203-276-7581",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 S Palisade Dr Ste 203",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "93454",
            "country_code": "US",
            "telephone_number": "805-354-7101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 S Palisade Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934545932",
            "country_code": "US",
            "telephone_number": "805-922-0481",
            "fax_number": "805-925-5261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAS KOBA",
        "first_name": "JADE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-04",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A162053",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME171297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125173600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmaskoba470946@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "LEE HEALTH SYSTEM INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.