Maria Anz Jacobs, DNP, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11013916 Issued in FL

Practice address

7730 West Boynton Beach Blvd.
Suite 3
Boynton Beach, FL 33437

Phone

(561) 877-1800

Fax

(561) 742-4480

NPI assigned

Jul 11, 2006

Last updated

Feb 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Maria Anz Kalick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premise Health of Georgia Medical PC

  dba Shaw Family Health Center

  • Multi-Specialty Clinic/Center
  • Dalton, GA
  • NPI 1588128656
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1497780464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7730 WEST BOYNTON BEACH BLVD.",
            "address_2": "SUITE 3",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33437",
            "telephone_number": "561-877-1800",
            "fax_number": "561-742-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7730 WEST BOYNTON BEACH BLVD.",
            "address_2": "SUITE 3",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33437",
            "telephone_number": "561-877-1800",
            "fax_number": "561-742-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "MARIA",
        "middle_name": "ANZ",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "2517262",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN230675",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11013916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "KALICK",
            "middle_name": "ANZ",
            "prefix": "DR.",
            "credential": "DNP, FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yalonda Nachole Jackson, MSN,ARNP
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• Jacob Pistor (Peak Recovery Services, LLC)
• Marty Jacob, MD
• Sheeba Jacob, ARNP
• Jacqueline B Pevny
• Julia Jacques, ARNP
• Jade Healing Collective
• Livia Angela Jaen, MD
• Lawrence Eric Jaffe, PT, SCS, ATC

• Nurse Practitioner in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.