Thomas Gerhard Jacoby, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D18148 Issued in NJ

Practice address

133B South Main Street
Milltown, NJ 08850

Phone

(732) 545-9009

Fax

(732) 545-9193

NPI assigned

Feb 19, 2007

Last updated

Aug 3, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Other, 1991

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Damian Family Care Centers, Inc.

  dba Project Samaritan Health Services

  • Federally Qualified Health Center (FQHC)
  • Jamaica, NY
  • NPI 1508955592
  Medicare reassignment NPD
• Damian Family Care Centers, Inc.

  dba Project Samaritan Health Services

  • Federally Qualified Health Center (FQHC)
  • Jamaica, NY
  • NPI 1487923595
  NPD

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249257600000",
    "number": "1639213853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEXINGTON AVENUE",
            "address_2": "#120",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10010",
            "telephone_number": "212-665-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133B SOUTH MAIN STREET",
            "city": "MILLTOWN",
            "state": "NJ",
            "postal_code": "08850",
            "telephone_number": "732-545-9009",
            "fax_number": "732-545-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "THOMAS",
        "middle_name": "GERHARD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2009-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0440881",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "D18148",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "044088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lynn Harris Kuiper, LPC, LCADC
• Alison Henry, RPH
• Christina Marie Hill
• Horizon Medical Supplies LLC
• Diane Jean Ivanov, LCSW
• Janine Essig LPC Lcadc LLC
• Joel R Kates, DPM
• Matthew A Kelleman, OD
• Kiara Physical Therapy LLC (Advanced Care Physical Therapy)
• Elissa Kay Koplik, PH.D.

• Dentist in Milltown, NJ
• Providers in Milltown, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2009; 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.