Justina Marie Jacob, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC5903 Issued in FL

Practice address

11925 Sheldon Rd
Tampa, FL 33626-3644

Phone

(727) 581-8760

NPI assigned

Jun 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Eye Physicians of Pinellas, PAGroup PAC ID 5092629071, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjacob@directaddress.net

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.

• The Eye Physicians of Pinellas, PA

  • Ophthalmology Physician
  • Largo, FL
  • NPI 1114925153

  Optometrist

  Medicare reassignment Care Compare group NPD
• Eye Doctors Optical Outlets PA

  • Optometrist
  • Orlando, FL
  • NPI 1164308771
  Medicare reassignment NPD
• Eye Doctors Optical Outlets PA

  • Optometrist
  • Tampa, FL
  • NPI 1114012689
  NPD
• Eye Doctors Optical Outlets PA

  • Optometrist
  • Sarasota, FL
  • NPI 1740471788
  NPD
• The Eye Physicians of Pinellas, PA

  • Durable Medical Equipment & Medical Supplies
  • Lakeland, FL
  • NPI 1790488013
  NPD
• The Eye Physicians of Pinellas, PA

  • Ambulatory Surgical Clinic/Center
  • Largo, FL
  • NPI 1366710741
  NPD (past)

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1972165058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W BAY DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337702203",
            "telephone_number": "727-581-8706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11925 SHELDON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336263644",
            "telephone_number": "727-581-8760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3220 N McMullen Booth Rd",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337612012",
            "country_code": "US",
            "telephone_number": "727-581-8706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 N Howard Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336061213",
            "country_code": "US",
            "telephone_number": "727-581-8706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "JUSTINA",
        "middle_name": "MARIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC005903",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Jackson
• Victoria Jackson
• Jaclyn Lewis-Croswell, Psy D PLLC
• Beena Jacob
• Jessen Jacob, M.D.
• Minu Jacob, APRN
• Rina Mary Jacob, MSN, APRN, FNP-C
• Sally Ann Jacob, DMD
• Salvin Jacob, DO
• Sarah Youssef Jacob, PHARMD, BCPS, BS

• Optometrist in Tampa, FL
• Providers in Tampa, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.
• 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.