Active NPI
Tom Jacob, DO
- Geriatric Psychiatry Physician
- Rochester, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Psychiatry Physician
- License
- 296407
- Practice address
- 315 Science Parkway
Rochester, NY 14620 - Phone
- (585) 602-1000
- NPI assigned
- Apr 7, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 296407 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Geriatric Psychiatry Physician | 2084P0805X | 296407 | NY | Primary |
Addresses
Primary practice location
315 Science Parkway
Rochester, NY 14620
Mailing address
315 Science Parkway
Rochester, NY 14620
Phone (585) 602-1000
Electronic endpoints 4
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | tom_jacob@urmc.rochester.edu | Health Information Exchange (HIE) | University of Rochester Medical Center |
| Direct Messaging Address | tjacob102300@direct.urmc.rochester.edu | Direct | |
| Direct Messaging Address | tjacob102300@direct.urmc.rochester.edu | Direct | |
| Direct Messaging Address | tjacob102300@direct.urmc.rochester.edu | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCCD Psychiatry Services PLLC | Current | Accepting new patients | |
| University of Rochester | Current | Accepting new patients | |
| University of Rochester | Current | Accepting new patients | |
| Acute Care Trauma of the University of Rochester | Current | Accepting new patients | |
| MCCD New Jersey Psychiatry Services LLC | Current | Accepting new patients | |
| Cardiac Surgery of the University of Rochester | Current | Accepting new patients | |
| University of Rochester | Current | Accepting new patients | |
| Nys Office of Mental Health | Past | Accepting new patients |
Locations
525 Route 73 N
Ste 117
Marlton, NJ 08053
Phone (609) 200-0444
109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572
300 Crittenden Blvd
Rochester, NY 14642
Phone (585) 275-3569
601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555
315 Science Pkwy
Rochester, NY 14620
Phone (585) 276-6900
2418 E York St
Philadelphia, PA 19125
Phone (215) 575-5906
Interoperability endpoints
- tjacob102300@direct.urmc.rochester.edu
Organizations & group practices 8
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.
-
- Psychiatry Physician
- New York, NY
- NPI 1033750823
-
- Internal Medicine Physician
- Rochester, NY
- NPI 1710226824
-
- Psychiatry Physician
- Hampton, NJ
- NPI 1023729530
-
- Surgical Critical Care Physician
- Rochester, NY
- NPI 1851754634
-
- Surgical Critical Care Physician
- Rochester, NY
- NPI 1689023277
-
- Community/Retail Pharmacy
- Rochester, NY
- NPI 1598476269
-
- Internal Medicine Physician
- Rochester, NY
- NPI 1821152588
-
- Psychiatric Hospital
- Rochester, NY
- NPI 1477617645
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1629464623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 SCIENCE PARKWAY",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "14620",
"telephone_number": "585-602-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 SCIENCE PARKWAY",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "14620",
"telephone_number": "585-602-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "TOM",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-07",
"last_updated": "2023-06-28",
"certification_date": "2023-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NY",
"license": "296407",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "NY",
"license": "296407",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "tom_jacob@urmc.rochester.edu",
"affiliation": "Y",
"endpointDescription": "Work email address",
"affiliationName": "University of Rochester Medical Center",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email address",
"address_1": "315 Science Parkway",
"city": "Rochester",
"state": "NY",
"country_code": "US",
"postal_code": "14620",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tjacob102300@direct.urmc.rochester.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "601 Elmwood Ave",
"city": "Rochester",
"state": "NY",
"country_code": "US",
"postal_code": "146420001",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tjacob102300@direct.urmc.rochester.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "601 Elmwood Ave",
"city": "Rochester",
"state": "NY",
"country_code": "US",
"postal_code": "146420001",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tjacob102300@direct.urmc.rochester.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "601 Elmwood Ave",
"city": "Rochester",
"state": "NY",
"country_code": "US",
"postal_code": "146420001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.