Individual provider Active NPI

Deasia Dominique Jacob, MD

  • Plastic and Reconstructive Surgery Physician
  • Frederick, MD
National Provider Identifier
1619339728
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
D0093827 Issued in MD
Practice address
501 W 7TH St
Frederick, MD 21701-4586
Phone
(240) 215-6310
Fax
(240) 439-8910
NPI assigned
Mar 28, 2016
Last updated
Jun 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X D93654 MD
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X D93654 MD
Plastic and Reconstructive Surgery Physician 2086S0122X D0093827 MD Primary

Addresses

Primary practice location

501 W 7TH St
Frederick, MD 21701-4586

Mailing address

400 W 7TH St
Frederick, MD 21701-4506

Other practice location 1

1562 Opossumtown Pike
Frederick, MD 21702-4920
Phone (240) 215-6310

Other practice location 2

141 Thomas Johnson Dr
Frederick, MD 21702-4502
Phone (301) 846-0100

Other practice location 3

1194 Dutchmans Creek Dr
Brunswick, MD 21716-9786
Phone (240) 215-6310

Other practice location 4

194 Thomas Johnson Dr
Frederick, MD 21702-4679
Phone (240) 215-6310

Other practice location 5

75 Thomas Johnson Dr
Frederick, MD 21702-4895
Phone (240) 215-6310

Other practice location 6

504 E Ridgeville Blvd
Mount Airy, MD 21771-5942
Phone (240) 215-6310

Other practice location 7

7211 Bank Ct
Frederick, MD 21703-8483
Phone (240) 215-6310

Other practice location 8

3430 Worthington Blvd
Frederick, MD 21704-7017
Phone (240) 215-6310

Other practice location 9

3000D Ventrie Ct
Myersville, MD 21773-7817
Phone (240) 215-6310

Other practice location 10

230 W Patrick St
Frederick, MD 21701-6945
Phone (240) 215-6310

Other practice location 11

15 E Frederick St
Walkersville, MD 21793-8234
Phone (240) 215-6310

Other practice location 12

400 W 7th St
Frederick, MD 21701-4506
Phone (240) 215-6310

Other practice location 13

16403 Old Emmitsburg Rd
Emmitsburg, MD 21727-8929
Phone (240) 215-6310

Other practice location 14

1 Frederick Health Way
Frederick, MD 21701-9435
Phone (240) 215-6310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220425000073 MD Practitioner - Plastic and Reconstructive Surgery 9931491941 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Howard University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 W 7TH St
Frederick, MD 21701-4586
Phone (301) 360-2574

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.07 of 100Reported as group
Quality
75.5
Promoting interoperability
100
Improvement activities
40
Cost
68.06

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0093827MDMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Medical Group LLC CurrentSince Sep 5, 2023 Accepting new patients
Johns Hopkins University Plastic Surgery CurrentSince Apr 6, 2022 Accepting new patients
Johns Hopkins University CurrentSince Apr 6, 2022 Accepting new patients
Frederick Health Medical Group LLC Current Accepting new patients
Frederick Health Medical Group LLC CurrentSince Sep 5, 2023 Accepting new patients
Johns Hopkins University Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4940 Eastern Ave
#A520
Baltimore, MD 21224

600 N Wolfe St
Baltimore, MD 21287

1194 Dutchmans Creek Dr
Brunswick, MD 21716
Phone (240) 566-3100

16403 Old Emmitsburg Rd
Emmitsburg, MD 21727
Phone (240) 566-3100

1 Frederick Health Way
Frederick, MD 21701
Phone (240) 439-8812

141 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 620-7478

1562 Opossumtown Pike
Frederick, MD 21702
Phone (240) 566-4500

194 Thomas Johnson Dr
Frederick, MD 21702
Phone (240) 215-6370

230 W Patrick St
Frederick, MD 21701
Phone (240) 215-6370

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

501 W 7th St
Frederick, MD 21701
Phone (301) 360-2574

75 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 631-3674

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

504 E Ridgeville Blvd
Mount Airy, MD 21771
Phone (301) 703-5452

3000D Ventrie Ct
Myersville, MD 21773
Phone (301) 663-3137

3430 Worthington Blvd
Urbana, MD 21704
Phone (240) 215-6900

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
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    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1619339728",
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            "address_1": "400 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506"
        },
        {
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        }
    ],
    "practiceLocations": [
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            "address_1": "1562 Opossumtown Pike",
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            "fax_number": "301-846-0244",
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        },
        {
            "address_1": "1194 Dutchmans Creek Dr",
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        {
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        {
            "address_1": "75 Thomas Johnson Dr",
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            "postal_code": "217024895",
            "country_code": "US",
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            "fax_number": "240-439-8910",
            "country_name": "United States",
            "address_type": "DOM"
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        {
            "address_1": "504 E Ridgeville Blvd",
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            "postal_code": "217715942",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "fax_number": "240-439-8910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7211 Bank Ct",
            "address_purpose": "LOCATION",
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            "state": "MD",
            "postal_code": "217038483",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "fax_number": "240-439-8910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3430 Worthington Blvd",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217047017",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "fax_number": "240-439-8910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000D Ventrie Ct",
            "address_purpose": "LOCATION",
            "city": "Myersville",
            "state": "MD",
            "postal_code": "217737817",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "fax_number": "240-439-8910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 W Patrick St",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217016945",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "fax_number": "240-439-8910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 E Frederick St",
            "address_purpose": "LOCATION",
            "city": "Walkersville",
            "state": "MD",
            "postal_code": "217938234",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "fax_number": "240-439-8910",
            "country_name": "United States",
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        },
        {
            "address_1": "400 W 7th St",
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            "country_code": "US",
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            "country_name": "United States",
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        },
        {
            "address_1": "16403 Old Emmitsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Emmitsburg",
            "state": "MD",
            "postal_code": "217278929",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "fax_number": "240-439-8910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Frederick Health Way",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217019435",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "fax_number": "240-439-8910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "DEASIA",
        "middle_name": "DOMINIQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MD",
            "license": "D93654",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "MD",
            "license": "D93654",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MD",
            "license": "D0093827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.