Elizabeth Jacob

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

298555 Issued in NY

Practice address

6 Wellness Way Ste G03
Latham, NY 12110-2135

Phone

(518) 785-5884

NPI assigned

Mar 24, 2017

Last updated

Sep 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

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 2

Specialty

General Surgery

Education

Virginia Commonwealth University, School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Peter's Hospital Hospital, Albany, NY, CCN 330057
• Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180

Merit-based Incentive Payment System (MIPS)

Final score

95.05 of 100Reported as apm

Quality

85.71

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

92.35 of 100Reported as group

Quality

98.76

Improvement activities

40

Cost

76.76

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elizabethjacob@ccp.allscriptsdirect.net

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.

• Community Care Physicians, PLLC

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1922048370

  Surgery

  Medicare reassignment Care Compare group NPD
• Valley Physician Services PC

  • Internal Medicine Physician
  • Paramus, NJ
  • NPI 1467815928
  Medicare reassignment NPD

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

• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727
  Care Compare affiliation
• St. Peter's Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  Care Compare affiliation

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1619408234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE G03",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102135",
            "telephone_number": "518-785-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA11829800",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "298555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shayna Beth Ireland, MS CCC SLP
• Sheri Irish, NYS LICENSED OPTICIA
• Carrie Isensee
• Lynn Everett Isernia, PT
• Jacqueline Ariel Isopo, LMHC
• Nuhar Jaleel
• Lisa M Janicke, RN
• Jason T. Decker, DDS and Nancy a. Cavotta DDS, PC. (Capital District Pediatric Dentistry)
• Elaine M Jaworski, MD
• Lalithapriya Jayakumar, M.D.

• Surgery Physician in Latham, NY
• Providers in Latham, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.