Thomas E. Jacob, D.P.M., P.C.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

59010000499 Issued in MI

Legal business name

THOMAS E. JACOB, D.P.M., P.C.

Practice address

23700 Gratiot Ave
Eastpointe, MI 48021-1647

Phone

(586) 779-1160

Fax

(586) 779-1163

NPI assigned

Oct 11, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Nannette M. Lingeman

Title

Office Manager

Phone

(586) 779-1160

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Patrick Burk, D.P.M.

  • Podiatrist
  • Novi, MI
  • NPI 1053348359
  NPD (past)
• Nemr M. Faraj, D.P.M.

  • Podiatrist
  • Southfield, MI
  • NPI 1356353981
  NPD (past)
• Syed M Ghani, DPM

  • Podiatrist
  • Eastpointe, MI
  • NPI 1174521439
  NPD (past)

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659369031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23700 GRATIOT AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480211647",
            "telephone_number": "586-779-1160",
            "fax_number": "586-779-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23700 GRATIOT AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480211647",
            "telephone_number": "586-779-1160",
            "fax_number": "586-779-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS E. JACOB, D.P.M., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LINGEMAN",
        "authorized_official_first_name": "NANNETTE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "586-779-1160",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "59010000499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE HEALTH PLAN",
            "identifier": "000000002745",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLNESS PLAN",
            "identifier": "1014915-0001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICE HMO",
            "identifier": "121471",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME MEDICARE",
            "identifier": "0737520001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HEALTH PLAN",
            "identifier": "101301",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Eastpointe, MI
• Providers in Eastpointe, MI by specialty
• Foot & Ankle Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.