Individual provider Active NPI

Ansu Jacob

  • Physician Assistant
  • New York, NY
National Provider Identifier
1679994529
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056682 Issued in PA
Practice address
156 William St RM 303
New York, NY 10038-5307
Phone
(888) 803-3770
Fax
(888) 803-3331
NPI assigned
Dec 19, 2013
Last updated
Mar 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA056682 PA Primary
Physician Assistant 363A00000X 028078 NY

Addresses

Primary practice location

156 William St RM 303
New York, NY 10038-5307

Mailing address

2046 Gorman St
Philadelphia, PA 19116-3914
Phone (267) 393-3496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140903000861 PA Practitioner - Physician Assistant 7214155308 Reassigns benefits to 1 organization
I20251205000369 NY Practitioner - Physician Assistant 7214155308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

333 1St St
Suite a
San Francisco, CA 94105-3060

440 Franklin St
Bloomfield, NJ 07003-4378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physician Inc. CurrentSince Oct 1, 2016 Accepting new patients
Temple Physicians Inc. CurrentSince Oct 1, 2016 Accepting new patients
Circle Medical Care of New York PC CurrentSince Sep 25, 2025 Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

333 1st St
Ste A
San Francisco, CA 94105
Phone (312) 724-7441

156 William St
Rm 303
New York, NY 10038
Phone (813) 955-6329

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1679994529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2046 GORMAN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163914",
            "telephone_number": "267-393-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 WILLIAM ST RM 303",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100385307",
            "telephone_number": "888-803-3770",
            "fax_number": "888-803-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "ANSU",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-19",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056682",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028078",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.