Mina Ayad Jacob, M.D.,FACC,FSCAI

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

31294 Issued in AL

Practice address

1700 Spring Hill Ave Ste 100
Mobile, AL 36604-1416

Phone

(251) 435-1200

Fax

(251) 435-6357

NPI assigned

May 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in GA, AL2 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 2

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Imc-Diagnostic and Medical Clinic LLCGroup PAC ID 2860399623, 168 clinicians

Tift Regional Health System IncGroup PAC ID 2062745169, 294 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mobile Infirmary Medical Center Hospital, Mobile, AL, CCN 010113
• Tift Regional Medical Center Hospital, Tifton, GA, CCN 110095
• Washington County Hospital Hospital, Chatom, AL, CCN 011300
• North Baldwin Infirmary Hospital, Bay Minette, AL, CCN 010129
• Monroe County Hospital Hospital, Monroeville, AL, CCN 011310
• Infirmary LTAC Hospital Long-term care hospital, Mobile, AL, CCN 012006

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mina.jacob@hca5.eclinicaldirectplus.com

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.

• Imc-Diagnostic and Medical Clinic LLC

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1447201066

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Tift Regional Health System Inc

  • Family Medicine Physician
  • Tifton, GA
  • NPI 1881203305
  Medicare reassignment Care Compare group NPD
• University of South Alabama

  • Family Medicine Physician
  • Mobile, AL
  • NPI 1992746838
  Medicare reassignment NPD
• USA Health Physician Billing Services LLC

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1720645468
  Medicare reassignment NPD
• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168
  Medicare reassignment NPD
• Kennestone Hospital, Inc.

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Medicare reassignment NPD
• Piedmont Cardiology of Atlanta, LLC

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1275729691
  Medicare reassignment NPD
• St. Francis Physician Practices LLC

  • Family Medicine Physician
  • Columbus, GA
  • NPI 1326749417
  Medicare reassignment NPD
• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229

  Cardiovascular Disease

  Medicare reassignment NPD
• Imc-Diagnostic and Medical Clinic LLC

  • Multi-Specialty Clinic/Center
  • Saraland, AL
  • NPI 1568235000
  NPD
• University of South Alabama

  • Clinical Medical Laboratory
  • Mobile, AL
  • NPI 1497859052
  NPD
• University of South Alabama

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1700241015
  NPD

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

• Gulf Health Hospitals, Inc

  • Family Medicine Physician
  • Bay Minette, AL
  • NPI 1154703726

  Hospital

  Care Compare affiliation
• Gulf Health Hospitals, Inc.

  • General Acute Care Hospital
  • Bay Minette, AL
  • NPI 1134164924
  Care Compare affiliation
• Gulf Health Hospitals, Inc.

  • Gynecology Physician
  • Bay Minette, AL
  • NPI 1760717870

  Hospital

  Care Compare affiliation
• Infirmary Health Hospitals, Inc.

  • Long Term Care Hospital
  • Mobile, AL
  • NPI 1437160157

  Long-term care hospital

  Care Compare affiliation
• Mobile Infirmary Association

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1558364802
  Care Compare affiliation
• Monroe County Health Care Authority

  • Critical Access Hospital
  • Monroeville, AL
  • NPI 1457392904
  Care Compare affiliation
• Washington County Healthcare Authority, Inc

  • Critical Access Hospital
  • Chatom, AL
  • NPI 1487699203
  Care Compare affiliation
• Tift Regional Health System Inc.

  • General Acute Care Hospital
  • Tifton, GA
  • NPI 1962462226
  Care Compare affiliation

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1730132556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SPRING HILL AVE STE 100",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041416",
            "telephone_number": "251-435-1200",
            "fax_number": "251-435-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SPRING HILL AVE STE 100",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041416",
            "telephone_number": "251-435-1200",
            "fax_number": "251-435-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "MINA",
        "middle_name": "AYAD",
        "credential": "M.D.,FACC,FSCAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adult Congenital Heart Disease",
            "state": "AL",
            "license": "31294",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AL",
            "license": "31294",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AL",
            "license": "31294",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AL",
            "license": "31294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000946844P",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000946844X",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000946844",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000946844K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000946844L",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000946844Q",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000946844R",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00946844A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000946844O",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167695",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle S. Jackson, M.D.
• Regina Jackson
• Savannah Rommel Jackson, MS, LCPC, ALC
• Sharcarus Jackson
• Sharie Jackson, MSN,RN
• Amy Adams Jacobs, CRNP
• John Clinton Jacobs V, M.D.
• Peyton Jacobs
• Samiksha Jain, MD
• Susan Jakoboski, NP

• Vascular Surgery Physician in Mobile, AL
• Providers in Mobile, AL by specialty
• Vascular Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.