Individual provider Active NPI

Bincy C Jacob, NP

  • Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1497128003
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP128909 Issued in TX
Practice address
8330 Abrams Rd Ste 112
Dallas, TX 75243-7590
Phone
(214) 342-4400
NPI assigned
Nov 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP128909 TX
Nurse Practitioner 363L00000X AP128909 TX Primary

Addresses

Primary practice location

8330 Abrams Rd Ste 112
Dallas, TX 75243-7590

Mailing address

8330 Abrams Rd Ste 112
Dallas, TX 75243-7590
Phone (214) 342-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220429001007 TX Practitioner - Nurse Practitioner 9335240118 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP128909TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince May 16, 2022 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince May 16, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Topcare Medical Group Inc Past Accepting new patients
Dallas Pediatrics and Children'S Healthcare, P.a. PastSince Dec 26, 2021 Accepting new patients
Vital Home Health Care, Inc PastSince Nov 4, 2006 Accepting new patients

Locations

12606 Greenville Ave
Ste 120
Dallas, TX 75243
Phone (214) 292-0072

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1497128003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8330 ABRAMS RD STE 112",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752437590",
            "telephone_number": "214-342-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8330 ABRAMS RD STE 112",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752437590",
            "telephone_number": "214-342-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "BINCY",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP128909",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP128909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.