Individual provider Active NPI

Harvey Richard Jacobs, D.P.M.

  • Podiatrist
  • Somerset, NJ
National Provider Identifier
1700890563
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
25MD00105100 Issued in NJ
Practice address
25 Clyde Road
Suite 101
Somerset, NJ 08873-5038
Phone
(732) 873-1111
Fax
(732) 873-1113
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00105100 NJ Primary

Addresses

Primary practice location

25 Clyde Road
Suite 101
Somerset, NJ 08873-5038

Mailing address

25 Clyde Road
Suite 101
Somerset, NJ 08873-5038
Phone (732) 873-1111

Other identifiers 1

IdentifierTypeStateIssuer
1240307MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20090216000197 NJ Practitioner - Podiatry 7416012026 Practice locations: Somerset, NJ

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Foot Care Center LLC Podiatrist Current Accepting new patients

Locations

25 Clyde Rd
Ste 101
Somerset, NJ 08873
Phone (732) 873-1111

Organizations & group practices 1

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229472000000",
    "number": "1700890563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CLYDE ROAD",
            "address_2": "SUITE 101",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088735038",
            "telephone_number": "732-873-1111",
            "fax_number": "732-873-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CLYDE ROAD",
            "address_2": "SUITE 101",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088735038",
            "telephone_number": "732-873-1111",
            "fax_number": "732-873-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "HARVEY",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2008-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00105100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1240307",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

Verify at the official NPI Registry.