Jessie Jacob MD Inc

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

JESSIE JACOB MD INC

Practice address

900 Welch Rd
Suite 101
Palo Alto, CA 94304-1805

Phone

(650) 617-8655

NPI assigned

Dec 6, 2012

Organization subpart

No

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

Authorized official

Name

Jessie K Jacob, MDNPI 1083644223

Title

President

Phone

(914) 282-6171

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessie K Jacob, MD

  • Diagnostic Radiology Physician
  • Palo Alto, CA
  • NPI 1083644223
  Medicare reassignment NPD Authorized official
• Diana F Guthaner, M.D.

  • Body Imaging Physician
  • Palo Alto, CA
  • NPI 1790737724
  NPD (past)

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354752000000",
    "number": "1972848638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WELCH RD",
            "address_2": "SUITE 101",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041805",
            "telephone_number": "650-617-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WELCH RD",
            "address_2": "SUITE 101",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041805",
            "telephone_number": "650-617-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSIE JACOB MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-06",
        "last_updated": "2012-12-06",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-282-6171",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENCE",
            "identifier": "A107083",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah B. Jeon, M.D.
• Marjorie Ann Jergentz-Stout, B.S.
• Hilary Rachel Jericho, MD
• Stephanie Lee Jessee, CPNP-AC
• Jessica Levatino MD Inc
• Samantha Jett
• Rosenda Dennette Jewell, LVN
• Jewish Family and Children'S Services
• Jeannie Jhu, PA-C
• Angela Xiangyi Ji, MD

• Radiology Clinic/Center in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Radiology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.