Active NPI
Jacob Small, PHD, ARNP-C
- Nurse Practitioner
- Palmetto Bay, FL
National Provider Identifier
1477550176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP2163832
- Practice address
- 13805 SW 78TH CT
Palmetto Bay, FL 33158-1109 - Phone
- (305) 972-2614
- NPI assigned
- Jul 7, 2005
- Reactivated
- Mar 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP2163832 | FL | Primary |
| Surgery Physician | 208600000X | ME51250 | FL |
Addresses
Primary practice location
13805 SW 78TH CT
Palmetto Bay, FL 33158-1109
Mailing address
13805 SW 78TH CT
Palmetto Bay, FL 33158-1109
Phone (305) 972-2614
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 304943400 | Medicaid | FL |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2000
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
651 E 25 St
Hialeah, FL 33013-3814
Phone (305) 431-0386
Hospital & facility affiliations
- Larkin Community Hospital Palm Springs Campus
- HCA Florida Kendall Hospital
- Jackson Health System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME51250 | FL | MD | Surgery Physician |
| ARNP2163832 | FL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Jacob Small, PA | Nurse Practitioner | Current | Accepting new patients |
Locations
651 E 25th St
Hialeah, FL 33013
Phone (305) 835-4370
372 W 47th St
Hialeah, FL 33012
Phone (305) 698-0112
Organizations & group practices 1
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.
-
- Nurse Practitioner
- Palmetto Bay, FL
- NPI 1649516030
Hospital & facility affiliations 25
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Miami, FL
- NPI 1013959972
-
- General Acute Care Hospital
- Miami, FL
- NPI 1710931522
-
- General Acute Care Hospital
- Hialeah, FL
- NPI 1013382860
-
- Psychiatric Hospital Unit
- Miami, FL
- NPI 1043473093
-
- Multi-Specialty Clinic/Center
- Miami, FL
- NPI 1578633707
Hospital
-
- Medical Specialty Clinic/Center
- Miami, FL
- NPI 1831263771
Hospital
-
- Multi-Specialty Clinic/Center
- Miami, FL
- NPI 1033283445
Hospital
-
- General Acute Care Hospital
- North Miami Beach, FL
- NPI 1104857119
-
- General Acute Care Hospital
- Palmetto Bay, FL
- NPI 1174601397
-
- General Acute Care Hospital
- Miami, FL
- NPI 1225033020
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715212800000",
"number": "1477550176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13805 SW 78TH CT",
"city": "PALMETTO BAY",
"state": "FL",
"postal_code": "331581109",
"telephone_number": "305-972-2614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13805 SW 78TH CT",
"city": "PALMETTO BAY",
"state": "FL",
"postal_code": "331581109",
"telephone_number": "305-972-2614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMALL",
"first_name": "JACOB",
"credential": "PHD, ARNP-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2024-05-09",
"certification_date": "2024-05-09",
"deactivation_date": "2006-03-20",
"reactivation_date": "2006-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP2163832",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME51250",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "304943400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palmetto Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.