Ryan Andre Jacob, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD.201551 Issued in LA

Practice address

4228 Houma Blvd
Suite 220
Metairie, LA 70006-3000

Phone

(504) 264-9353

Fax

(504) 301-9312

NPI assigned

Aug 8, 2007

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in LA

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

General Surgery

Education

Louisiana State University School of Medicine in New Orleans, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Jefferson Physicians Group LLCGroup PAC ID 4587660402, 211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176

Procedures performed for Medicare patients

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.

• East Jefferson Physicians Group LLC

  • Internal Medicine Physician
  • New Orleans, LA
  • NPI 1922293372
  Medicare reassignment Care Compare group NPD
• Jacob General Surgery, LLC

  • Surgery Physician
  • Metairie, LA
  • NPI 1003246828
  Medicare reassignment NPD Authorized official
• Metairie Physician Services Inc.

  • Internal Medicine Physician
  • Metairie, LA
  • NPI 1801233648
  NPD (past)

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

• University Healthcare System, L.C.

  • Ambulance
  • Metairie, LA
  • NPI 1023717683

  Hospital

  Care Compare affiliation
• University Healthcare System, L.C.

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1033611454
  Care Compare affiliation
• University Healthcare System, L.C.

  dba East Jefferson General Hospital

  • General Acute Care Hospital
  • Metairie, LA
  • NPI 1497792527
  Care Compare affiliation
• University Healthcare System, L.C.

  dba Lakeview Regional Behavioral Health

  • Psychiatric Hospital Unit
  • Covington, LA
  • NPI 1790722825
  Care Compare affiliation

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1942491394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 HOUMA BLVD",
            "address_2": "SUITE 220",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700063000",
            "telephone_number": "504-264-9353",
            "fax_number": "504-301-9312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 HOUMA BLVD",
            "address_2": "SUITE 220",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700063000",
            "telephone_number": "504-264-9353",
            "fax_number": "504-301-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "RYAN",
        "middle_name": "ANDRE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "MD.201551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2160613",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Dent DDS. Metairie Modern Dentistry a Professional Corporation (Metairie Modern Dentistry)
• Jacob General Surgery, LLC
• Jasmine Jacob
• Leah Gonsoulin Jacob, M.D.
• Rudolph Daniel Jacob, M.D.
• Jeanne Mireille Jacobi-Marino, LOTR
• Benjamin F. Jacobs III, MD
• Jacqueline R. Faust, DDS, LLC
• Jacquelyn a Walther, LPC, NCC
• Ashwin Pannathpur Jaikishen, M.D.

• Surgery Physician in Metairie, LA
• Providers in Metairie, LA by specialty
• Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.