Shaheen Kaka Jacob, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

P3736 Issued in TX

Practice address

4323 N Josey LN
Suite 306
Carrollton, TX 75010-4633

Phone

(972) 939-7011

Fax

(972) 939-2951

NPI assigned

Apr 18, 2008

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/
• Direct secure messaging: shaheen.jacob.1@11541.direct.athenahealth.com

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.

• Texas Health Presbyterian Hospital Plano

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1770514077
  NPD (past)

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451692800000",
    "number": "1881868958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4323 N JOSEY LN",
            "address_2": "SUITE 306",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104633",
            "telephone_number": "972-939-7011",
            "fax_number": "972-939-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4323 N JOSEY LN",
            "address_2": "SUITE 306",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104633",
            "telephone_number": "972-939-7011",
            "fax_number": "972-939-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SHAHEEN",
        "middle_name": "KAKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-18",
        "last_updated": "2016-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "P3736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "309929YUD",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "P3736",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "327547101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Aryn Jackson, DDS
• Miranda S Jackson, LPC
• Robert E Jackson, D.D.S.
• Arun Jacob, MD
• Sara Jacob, APRN-CNP
• Siji Jacob, PHARM D
• Peter David Jaillet, DC
• James L Tritton DDS PC
• Jamie James, M.A., LPC
• Jamjen Enterprises Incorporated

• Obstetrics & Gynecology Physician in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.