Mark Alan Jacob, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

F4114 Issued in TX

Practice address

4330 Medical Dr Ste 500
San Antonio, TX 78229-3318

Phone

(210) 558-0122

Fax

(210) 558-0120

NPI assigned

Apr 11, 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 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Internal MedicineAlso: Cardiovascular Disease (Cardiology)

Education

University of Texas Medical Branch at Galveston, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uvalde Medical and Surgical AssociatesGroup PAC ID 3971650672, 13 clinicians

Wellmed Networks, Inc.Group PAC ID 6002091261, 116 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uvalde Memorial Hospital Hospital, Uvalde, TX, CCN 451387

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Uvalde Medical and Surgical Associates

  • Surgery Physician
  • Uvalde, TX
  • NPI 1730324500
  Medicare reassignment Care Compare group NPD
• Wellmed Networks, Inc.

  • Cardiovascular Disease Physician
  • San Antonio, TX
  • NPI 1386948677
  Medicare reassignment Care Compare group NPD
• Uvalde Medical and Surgical Associates

  • Rural Health Clinic/Center
  • Uvalde, TX
  • NPI 1891126959
  NPD
• Wellmed Medical Group, PA

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1437156486
  NPD (past)

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

• Uvalde County Hospital Authority

  • Critical Access Hospital
  • Uvalde, TX
  • NPI 1740288505
  Care Compare affiliation

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1952524399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 MEDICAL DR STE 500",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293318",
            "telephone_number": "210-558-0122",
            "fax_number": "210-558-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 MEDICAL DR STE 500",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293318",
            "telephone_number": "210-558-0122",
            "fax_number": "210-558-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "F4114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135747703",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED NETWORKS INC",
            "identifier": "TXB150108",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vadean L. Jackson, M.D.
• Valencia Jackson
• Whitney Jackson, CFNP
• Whitney Ree Ann Jackson, LCDC I
• Jerin Jacob, DDS
• Rene Nanette Jacob, MBA, RD, LD
• Robin Jacob, MD
• Juliette Jacobi, OTR/L
• Narlin Jacobo
• Jacobs & Ramirez Allergy & Immunology

• Cardiovascular Disease Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Cardiovascular Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.