Active NPI
Sera Ann Jacob, DO
- Family Medicine Physician
- Spokane, WA
National Provider Identifier
1821739798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DOL.OL.61508494
- Practice address
- 3919 N Maple St
Spokane, WA 99205-1349 - Phone
- (509) 444-8200
- Fax
- (509) 434-0392
- NPI assigned
- Apr 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DOL.OL.61508494 | WA | Primary |
Addresses
Primary practice location
3919 N Maple St
Spokane, WA 99205-1349
Mailing address
731 N Iron Bridge Way
Spokane, WA 99202-4926
Phone (509) 444-8888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of North Texas HSC, College of Osteopathic Med, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3919 N Maple St
Spokane, WA 99205-1349
Phone (509) 444-8888
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DOL.OL.61508494 | WA | MD | Family Medicine Physician |
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.
-
- Federally Qualified Health Center (FQHC)
- Spokane, WA
- NPI 1326005851
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765324800000",
"number": "1821739798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "731 N IRON BRIDGE WAY",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992024926",
"telephone_number": "509-444-8888",
"fax_number": "509-444-7806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3919 N MAPLE ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992051349",
"telephone_number": "509-444-8200",
"fax_number": "509-434-0392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "SERA",
"middle_name": "ANN",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-05",
"last_updated": "2025-12-10",
"certification_date": "2025-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "DOL.OL.61508494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.
- 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.