Organization Active NPI

Ruth M. Jacobs, MD, LLC

  • Infectious Disease Physician
  • Rockville, MD
National Provider Identifier
1588019079
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
D29526 Issued in MD
Legal business name
RUTH M. JACOBS, MD, LLC
Practice address
9420 Key West Ave
Suite 202
Rockville, MD 20850-3334
Phone
(301) 315-9515
NPI assigned
May 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Authorized official

Name
Dr. Ruth Marie Jacobs, M.D.NPI 1497774913
Title
Owner
Phone
(301) 315-9515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X D29526 MD Primary

Addresses

Primary practice location

9420 Key West Ave
Suite 202
Rockville, MD 20850-3334

Mailing address

9420 Key West Ave
Suite 202
Rockville, MD 20850-3334
Phone (301) 315-9515

Other identifiers 1

IdentifierTypeStateIssuer
756621200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171109002513 DC Part B Supplier - Clinic/Group Practice 3971869819 Receives reassigned benefits from 1 practitioner
Practice locations: Germantown, MD

National Provider Directory

National Provider Directory

Locations

19851 Observation Dr
Ste 245
Germantown, MD 20876
Phone (301) 288-1319

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462233600000",
    "number": "1588019079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 KEY WEST AVE",
            "address_2": "SUITE 202",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503334",
            "telephone_number": "301-315-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9420 KEY WEST AVE",
            "address_2": "SUITE 202",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503334",
            "telephone_number": "301-315-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTH M. JACOBS, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-315-9515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MD",
            "license": "D29526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "756621200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.