Samuel Laban Jacobs, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME124293 Issued in FL

Practice address

780 SW 24TH St
Fort Lauderdale, FL 33315-2643

Phone

(954) 412-7252

Fax

(954) 848-2685

NPI assigned

Nov 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Florida Department of Health

  • Public Health or Welfare Agency
  • Fort Lauderdale, FL
  • NPI 1073580890
  Medicare reassignment NPD
• Florida Department of Health

  • Public Health or Welfare Agency
  • Bronson, FL
  • NPI 1154395390
  NPD
• Cooper Obstetrical Associates, PC

  • Obstetrics & Gynecology Physician
  • Camden, NJ
  • NPI 1194745976
  NPD (past)
• University Urogynecology Association, PC

  • Obstetrics & Gynecology Physician
  • Voorhees, NJ
  • NPI 1255352423
  NPD (past)

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1881677508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 SW 24TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333152643",
            "telephone_number": "954-467-4700",
            "fax_number": "954-467-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 SW 24TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333152643",
            "telephone_number": "954-412-7252",
            "fax_number": "954-848-2685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 S Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191461613",
            "country_code": "US",
            "telephone_number": "215-685-6576",
            "fax_number": "215-685-6592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "SAMUEL",
        "middle_name": "LABAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA06031700",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD039416L",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "PA",
            "license": "MD039416L",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "NJ",
            "license": "25MA060317100",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME124293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0157600300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ayden Jacob, MD
• Kurien Jacob, MD
• Martin Lee Jacob, MD
• Beth Singer Jacobs, D.O
• Jon Stephen Jacobs, O.D.
• Stephen F. Jacobs, M.D.
• Emma Arielle Jacobson, LMHC
• Jennifer Jacobson, PSYD
• Mitchell Mayer Jacobson, M.D.
• Steven Jacobson, DC

• Obstetrics & Gynecology Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.