Beena Jacob

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5011196 Issued in NC

Practice address

4505 Fair Meadows LN Ste 101
Raleigh, NC 27607-6449

Phone

(919) 787-4000

NPI assigned

Nov 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Duke University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Essential Geriatric Care PAGroup PAC ID 4789766510, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.67 of 100Reported as group

Quality

88.12

Improvement activities

40

Cost

77.69

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Essential Geriatric Care, PA

  • Geriatric Medicine (Internal Medicine) Physician
  • Hillsborough, NC
  • NPI 1912190281
  Medicare reassignment Care Compare group NPD
• Apogee Medical Group North Carolina

  • Hospitalist Physician
  • Scottsdale, AZ
  • NPI 1043518228

  NC

  Medicare reassignment NPD

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1568930113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 FINISH LINE RD",
            "city": "BAHAMA",
            "state": "NC",
            "postal_code": "275039657",
            "telephone_number": "919-479-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 FAIR MEADOWS LN STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076449",
            "telephone_number": "919-787-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "BEENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Jackson I, M.ED. CCC-SLP
• Tiffany Jackson, M.ED., CCC/SLP
• Tracy Lamont Jackson
• Wilma P Jackson
• Amritha Jacob
• Bobby Mathew Jacob, M.D.
• Giuseppina Andrawis Jacob, DO
• Briana Jacobs
• Jaconna Salene Jacobs
• James Curtis Jacobs, MD

• Nurse Practitioner in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.