Leslie Jacob, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME66002 Issued in FL

Practice address

4200 Sun N Lake Blvd
Sebring, FL 33872-1986

Phone

(863) 402-3103

Fax

(863) 402-5339

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in FL, VA, SC, IN5 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 5

Specialty

GastroenterologyAlso: Internal Medicine

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians

Porter Physician Services LLCGroup PAC ID 1850482407, 96 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
• Northwest Health - Porter Hospital, Valparaiso, IN, CCN 150035
• Adventhealth Ocala Hospital, Ocala, FL, CCN 100062
• Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: ljacob26180@epicdirect.hf.org

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.

• Health First Medical Group, LLC

  • General Practice Physician
  • Melbourne, FL
  • NPI 1750626495

  Gastroenterology

  Medicare reassignment Care Compare group NPD
• Porter Physician Services LLC

  • Family Medicine Physician
  • Valparaiso, IN
  • NPI 1508075680
  Medicare reassignment Care Compare group NPD
• Adventist Health System-Sunbelt Inc

  • General Acute Care Hospital
  • Sebring, FL
  • NPI 1083692594
  Medicare reassignment NPD
• Musc Community Physicians

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006

  Gastroenterology

  Medicare reassignment NPD
• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270

  Gastroenterology

  Medicare reassignment NPD
• Adventist Health System-Sunbelt Inc

  • Rural Health Clinic/Center
  • Avon Park, FL
  • NPI 1881850956
  NPD
• Health First Medical Group, LLC

  • General Practice Physician
  • Rockledge, FL
  • NPI 1073268934
  NPD
• Musc Community Physicians

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772
  NPD
• Musc Community Physicians

  • Family Medicine Physician
  • Bamberg, SC
  • NPI 1992383145
  NPD
• Carolina Family Care, Inc

  • Internal Medicine Physician
  • North Charleston, SC
  • NPI 1649533662
  NPD (past)
• Porter Physician Services LLC

  • Internal Medicine Physician
  • Portage, IN
  • NPI 1457566309
  NPD (past)
• Regional Medical Center of Orangeburg and Calhoun Counties

  • Community/Retail Pharmacy
  • Orangeburg, SC
  • NPI 1467709881
  NPD (past)

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

• Florida Hospital Ocala Inc

  • General Acute Care Hospital
  • Ocala, FL
  • NPI 1740772268
  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • Air Ambulance
  • Melbourne, FL
  • NPI 1235312281

  Hospital

  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1295702728
  Care Compare affiliation
• Porter Hospital LLC

  • General Acute Care Hospital
  • Valparaiso, IN
  • NPI 1215151154
  Care Compare affiliation
• Sanford Health of Northern Minnesota

  • Ambulatory Surgical Clinic/Center
  • Bemidji, MN
  • NPI 1093876922

  Hospital

  Care Compare affiliation
• Sanford Medical Center Fargo

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924

  Hospital

  Care Compare affiliation
• Sanford Medical Center Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1245519081
  Care Compare affiliation
• Sanford Medical Center Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  Care Compare affiliation
• Sanford Medical Center Fargo

  • Air Ambulance
  • Fargo, ND
  • NPI 1942415468

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1679647697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 YACHT CLUB DR APT 1202",
            "address_2": "SUITE # 205",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331803546",
            "telephone_number": "561-756-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338721986",
            "telephone_number": "863-402-3103",
            "fax_number": "863-402-5339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 W Cocoa Beach Cswy",
            "address_purpose": "LOCATION",
            "city": "Cocoa Beach",
            "state": "FL",
            "postal_code": "329315595",
            "country_code": "US",
            "telephone_number": "321-868-5871",
            "fax_number": "321-868-5852",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "824 N Military Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235023652",
            "country_code": "US",
            "telephone_number": "888-236-2263",
            "fax_number": "750-390-4551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3610 Yacht Club Dr Apt 1202",
            "address_purpose": "LOCATION",
            "city": "Aventura",
            "state": "FL",
            "postal_code": "331803546",
            "country_code": "US",
            "telephone_number": "561-756-5606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "LESLIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101280924",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME66002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119868200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HFMG MA",
            "identifier": "RM822",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100011557",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FLA",
            "identifier": "28906",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• J.Bolaram,MD &Associates,P.a
• Jabbertalky Inc.
• Hadley Louise Jackson
• Jashavia Jackson
• Terry Elizabeth Jackson, LMHC
• Mary Elizabeth Jahna, BA
• Walter Mason Jahna, APRN
• Aktar Dean Jaman, MD
• Jerry Durables Jamora, DPT
• Jana Grooms Counseling and Consulting, LLC

• Gastroenterology Physician in Sebring, FL
• Providers in Sebring, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.