Individual provider Active NPI

Tom Jacob, DO

  • Geriatric Psychiatry Physician
  • Rochester, NY
National Provider Identifier
1629464623
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
296407 Issued in NY
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

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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, NJ2 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

Enrollment IDStateProvider typePAC IDDetails
I20210201000293 NY Practitioner - Psychiatry 1658621644 Reassigns benefits to 2 organizations
I20240424002800 NJ Practitioner - Psychiatry 1658621644 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD Psychiatry Services PLLC CurrentSince Mar 1, 2024 Accepting new patients
University of Rochester Current Accepting new patients
University of Rochester CurrentSince Jul 1, 2020 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
MCCD New Jersey Psychiatry Services LLC CurrentSince Apr 4, 2024 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Jul 1, 2020 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.