Diana Mary Jacob, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11109 Issued in TX

Practice address

5323 Harry Hines Blvd Stop 7200
Dallas, TX 75390-7201

Phone

(214) 648-6400

Fax

(214) 648-5461

NPI assigned

Feb 28, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Diagnostic Radiology Physician
  • Dallas, TX
  • NPI 1972579365
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1760452767
  NPD (past)

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1801336524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD STOP 7200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907201",
            "telephone_number": "214-648-6400",
            "fax_number": "214-648-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "DIANA",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-28",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "567258YNGS",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "567259YL7B",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "567256YL7A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Roffe MD PA
• Alison Beth Jacob, MOT, OTR
• Bincy C Jacob, NP
• Christy M Jacob, OTR/L
• Denny Poikayil Jacob, M.D.
• Guilla Aequielle Santos Jacob, CRNA
• Jeena Jacob, PNP
• Jeena Jacob, PHARMD
• Jency Jacob, CRNA
• Lena Jacob, PA-C

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.