Individual provider Active NPI

Sargon Jacob

  • Anesthesiology Physician
  • Santa Cruz, CA
National Provider Identifier
1497725220
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20A7956 Issued in CA
Practice address
2900 Chanticleer Ave
Santa Cruz, CA 95065-1816
Phone
(831) 477-2288
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20A7956 CA Primary

Addresses

Primary practice location

2900 Chanticleer Ave
Santa Cruz, CA 95065-1816

Mailing address

2025 Soquel Ave
Santa Cruz, CA 95062-1323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20041026001002 CA Practitioner - Anesthesiology 3870554439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

2900 Chanticleer Ave
Santa Cruz, CA 95065-1816
Phone (831) 477-2208

Hospital & facility affiliations

  • Sutter Maternity & Surgery Center of Santa Cruz Hospital, Santa Cruz, CA, CCN 050714

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A7956CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Sep 28, 2013 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Sep 28, 2013 Accepting new patients
Santa Cruz Medical Clinic, Inc Past Accepting new patients
Pacific Point Podiatry Inc Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

160 Green Valley Rd
Ste 101
Freedom, CA 95019
Phone (831) 636-4915

160 Green Valley Rd
Ste 10
Freedom, CA 95019
Phone (831) 763-9700

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

795 El Camino Real
#1112
Palo Alto, CA 94301

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

2900 Chanticleer Ave
Santa Cruz, CA 95065
Phone (831) 477-2200

2025 Soquel Ave
Santa Cruz, CA 95062
Phone (408) 423-4111

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

75 Nielson St
Watsonville, CA 95076
Phone (831) 724-4741

Interoperability endpoints

  • Direct secure messaging: sjacobmd33216@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 1

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1497725220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SOQUEL AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CHANTICLEER AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651816",
            "telephone_number": "831-477-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SARGON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A7956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.