Tina Jacob, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0098428 Issued in MD

Practice address

4924 Campbell Blvd
Nottingham, MD 21236-5908

Phone

(410) 955-5000

NPI assigned

May 27, 2020

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

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Family Practice

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Johns Hopkins Community Physicians, IncGroup PAC ID 8325943707, 764 clinicians

Champion Physical Therapy LLC HallsGroup PAC ID 1355416306, shared by 4 NPIs, 277 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Johns Hopkins Home Health Services, Inc Home health agency, Baltimore, MD, CCN 217081
• Johns Hopkins Hospital, the Hospital, Baltimore, MD, CCN 210009
• Johns Hopkins Bayview Medical Center Hospital, Baltimore, MD, CCN 210029
• Umd Upper Chesapeake Medical Center Hospital, Bel Air, MD, CCN 210049

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjacob1151861@direct.hopkinsmedicine.org

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.

• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1578598868
  Medicare reassignment Care Compare group NPD
• Johns Hopkins Community Physicians

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1124629837
  NPD
• Johns Hopkins Community Physicians

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1356161806
  NPD

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

• The Johns Hopkins Home Health Services, Inc.

  • Home Health Agency
  • Baltimore, MD
  • NPI 1669551321
  Care Compare affiliation Name & address match
• Johns Hopkins Bayview Medical Center Inc

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1790700904
  Care Compare affiliation
• Johns Hopkins Bayview Medical Center, Inc.

  • Chronic Disease Hospital
  • Baltimore, MD
  • NPI 1336251412
  Care Compare affiliation
• The Johns Hopkins Hospital

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1578597993
  Care Compare affiliation
• Upper Chesapeake Medical Center, Inc.

  • General Acute Care Hospital
  • Bel Air, MD
  • NPI 1598761355
  Care Compare affiliation

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1851914675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "806-743-6130",
            "fax_number": "806-743-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4924 CAMPBELL BLVD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212365908",
            "telephone_number": "410-955-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794300002",
            "country_code": "US",
            "telephone_number": "806-743-6130",
            "fax_number": "806-743-3955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0098428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meaghan Isaacs, SLP
• Kira Isbert
• Paula Joy Ison, PMHNP-BC
• Asia K Jackson, LCPC
• Moriah M Jackson
• Jayden Jacobs
• Gail A Jacoby, MD
• James Adleberg DPM, P.a.
• James Adleberg DPM, P.a.
• Charis James, M.D.

• Family Medicine Physician in Nottingham, MD
• Providers in Nottingham, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; 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.