Eduardo Jacobs

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301097822 Issued in MI

Practice address

42301 Mound Rd
Sterling Heights, MI 48314-3148

Phone

(586) 557-4441

NPI assigned

Sep 17, 2019

Last updated

Sep 17, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Continuous Transportation

  • Driver
  • Utica, MI
  • NPI 1689231532

  Single Specialty

  NPD Authorized official
• New Clear Images

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Dearborn, MI
  • NPI 1861038168
  NPD Authorized official
• Phoenix Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Utica, MI
  • NPI 1326603036
  NPD Authorized official

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1518517028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1465",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480901465",
            "telephone_number": "586-557-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42301 MOUND RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143148",
            "telephone_number": "586-557-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "EDUARDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301097822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LARA",
            "identifier": "802322652",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamika Jackson
• Jacob Kalo, M.D., P.C.
• Pius Jacob, PHYSICAL THERAPIST
• Sereena Grace Jacob
• Sherine Susan Jacob
• Judy Lynn Jacobs, PHD
• Samuel Cole Jacobson, OTRL
• Syed Abbas H. Jafri, M.D.
• Edyta Jagustin, P.T.
• Aditi Jaidka, MD

• General Practice Physician in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.