Individual provider Active NPI

Michael R Jacoby, MD

  • Surgery Physician
  • Inverness, FL
National Provider Identifier
1811911993
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME105854 Issued in FL
Practice address
403 W Highland Blvd
Inverness, FL 34452-4717
Phone
(352) 726-3646
Fax
(352) 726-0079
NPI assigned
Jul 26, 2006
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 54194-20 WI
Surgery Physician 208600000X ME105854 FL Primary
Surgery Physician 208600000X 036046008 IL

Addresses

Primary practice location

403 W Highland Blvd
Inverness, FL 34452-4717

Mailing address

403 W Highland Blvd
Inverness, FL 34452-4717
Phone (352) 726-3646

Other identifiers 2

IdentifierTypeStateIssuer
036046008MedicaidIL
04929950OtherILBC BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170508000135 FL Practitioner - General Surgery 5698757136 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
USA Vein Clinics of Miami LLCGroup PAC ID 9830404003, 11 clinicians

Practice addresses (Care Compare)

1711 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4621
Phone (954) 688-3968

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Manuel E Abella MD PA CurrentSince Jan 20, 2026 Accepting new patients
USA Vein Clinics of Miami, LLC CurrentSince May 15, 2020 Accepting new patients
USA Vascular Centers of Miami PLLC CurrentSince May 15, 2020 Accepting new patients
Global Care S.C. PastSince Sep 14, 2025 Accepting new patients
USA Vascular Centers of Miami, PLLC PastSince Nov 19, 2023 Accepting new patients
Vascular Anesthesia Associates PLLC PastSince May 15, 2020 Accepting new patients
USA Vascular Centers of Miami, PLLC PastSince Nov 19, 2023 Accepting new patients
USA Vascular Centers of Miami, PLLC PastSince Aug 28, 2021 Accepting new patients
Gulf Coast Vein Center, P.a. Past Accepting new patients
Advanced Surgical Care of Northern Illinois, LTD Surgery PastSince Jan 1, 2001 Accepting new patients
USA Vein Clinics of Miami, LLC PastSince Feb 19, 2023 Accepting new patients

Locations

19451 S Tamiami Trl
Ste C
Fort Myers, FL 33908
Phone (239) 747-2133

19451 S Tamiami Trl
Ste E
Fort Myers, FL 33908
Phone (239) 747-2133

1711 E Hallandale Beach Blvd
Hallandale Beach, FL 33009
Phone (954) 457-0064

1711 E Hallandale Beach Blvd
Ste A
Hallandale Beach, FL 33009
Phone (954) 688-3968

1711 E Hallandale Beach Blvd
Ste B
Hallandale Beach, FL 33009
Phone (546) 883-9689

7100 W 20th Ave
Ste 412
Hialeah, FL 33016
Phone (954) 322-1110

13241 Bartram Park Blvd
Unit 801
Jacksonville, FL 32258
Phone (904) 446-9191

1975 S John Young Pkwy
Ste 101
Kissimmee, FL 34741
Phone (407) 715-6062

13940 N US Highway 441
Ste 500
Lady Lake, FL 32159
Phone (352) 218-8638

13940 N US Highway 441
Ste 500A
Lady Lake, FL 32159
Phone (352) 218-8638

13936 NW 7th Ave
Miami, FL 33168
Phone (305) 364-5778

3399 NW 72nd Ave
Ste 101A
Miami, FL 33122
Phone (786) 698-8734

8200 SW 117th Ave
Ste 414
Miami, FL 33183
Phone (305) 221-6161

4978 Millenia Blvd
Ste D
Orlando, FL 32839
Phone (321) 666-7620

4900 95th Ave N
Pinellas Park, FL 33782
Phone (727) 546-4400

4900 95th Ave N
Ste C
Pinellas Park, FL 33782
Phone (727) 475-7751

4900 95th Ave N
Ste E
Pinellas Park, FL 33782
Phone (727) 475-7751

2400 Fruitville Rd
Ste E
Sarasota, FL 34237

5409 N State Road 7
Tamarac, FL 33319
Phone (786) 567-4850

5409 N State Road 7
Ste A
Tamarac, FL 33319
Phone (754) 357-0369

4726 N Habana Ave
Ste 204
Tampa, FL 33614
Phone (813) 773-0988

Organizations & group practices 11

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1811911993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W HIGHLAND BLVD",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524717",
            "telephone_number": "352-726-3646",
            "fax_number": "352-726-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W HIGHLAND BLVD",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524717",
            "telephone_number": "352-726-3646",
            "fax_number": "352-726-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "54194-20",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME105854",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036046008",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036046008",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "04929950",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inverness, FL

Sources for this page

Verify at the official NPI Registry.