Active NPI
Jubie Jacob, PA-C
- Physician Assistant
- Cortlandt Manor, NY
National Provider Identifier
1558083501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 029120
- Practice address
- 1980 Crompond Rd
Cortlandt Manor, NY 10567-4144 - Phone
- (914) 737-9000
- NPI assigned
- Sep 15, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 6221 | CT | |
| Physician Assistant | 363A00000X | 029120 | NY | Primary |
Addresses
Primary practice location
1980 Crompond Rd
Cortlandt Manor, NY 10567-4144
Mailing address
1980 Crompond Rd
Cortlandt Manor, NY 10567-4144
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ | Health Information Exchange (HIE) | |
| Direct Messaging Address | fjo9005@direct.nyp.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 029120 | NY | MD | Physician Assistant |
Interoperability endpoints
- fjo9005@direct.nyp.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785715200000",
"number": "1558083501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1980 CROMPOND RD",
"city": "CORTLANDT MANOR",
"state": "NY",
"postal_code": "105674144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1980 CROMPOND RD",
"city": "CORTLANDT MANOR",
"state": "NY",
"postal_code": "105674144",
"telephone_number": "914-737-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "JUBIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-15",
"last_updated": "2026-08-03",
"certification_date": "2026-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CT",
"license": "6221",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "029120",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "1980 Crompond Rd",
"city": "Cortlandt Manor",
"state": "NY",
"country_code": "US",
"postal_code": "105674144",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "1980 Crompond Rd",
"city": "Cortlandt Manor",
"state": "NY",
"country_code": "US",
"postal_code": "105674144",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "fjo9005@direct.nyp.org",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Address",
"address_1": "1980 Crompond Rd",
"city": "Cortlandt Manor",
"state": "NY",
"country_code": "US",
"postal_code": "105674144",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cortlandt Manor, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.