Active NPI 1902283211 Individual Practitioner Male Practitioner

Dr. Emmanuel P Jacob , MD

Surgery • Miramar, FL

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Emmanuel Jacob, MD is a certified Surgery practicing in Miramar, FL. With approximately 27 years of clinical experience since completing medical education in 1999, Dr. Jacob delivers high-quality medical care to the local community at 3601 SW 160TH AVE STE 250.

Dr. Jacob is affiliated with Vohra Post Acute Care Physicians Of The Northeast Pa and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least, subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least, removal of skin and tissue, 20.0 sq cm or less. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

3601 Sw 160th Ave Ste 250

Miramar, FL 330276314

Telephone 8778667123

Associated Practice Facility / Clinic

🏢 Vohra Wound Physicians Of Fl, Llc Facility NPI 1629374327

Medicare Profile & Education

Medical School

Other

Graduation Year

1999

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Miramar, FL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

27 Yrs +3.5 yrs vs City Avg

City Avg: 23.5 Yrs

State Avg: 26.3 Yrs

Regional Practice Density

39 Specialists

Practicing in Miramar, FL (2030 Statewide)

Telehealth Adoption Rate

17.9% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

59.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Jacob (27 Years) 27 Yrs

Miramar Specialty Average (23.5 Years) 23.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	1,716	311	$174.94	$80.01
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	1,327	287	$252.10	$115.68
11042 Removal of skin and tissue, 20.0 sq cm or less	935	135	$336.90	$135.77
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	825	308	$174.94	$79.49
97597 Removal of tissue from wound, 20.0 sq cm or less	776	112	$264.42	$112.11
17250 Application of chemical to stop tissue regrowth in wound	718	133	$230.66	$76.97
11042 Removal of skin and tissue, 20.0 sq cm or less	515	143	$336.90	$58.70
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	482	83	$574.74	$252.97
97610 Therapy procedure using ultrasound	480	49	$1196.36	$487.63
17250 Application of chemical to stop tissue regrowth in wound	466	147	$230.66	$29.61
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	446	232	$252.10	$114.96
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	269	69	$574.74	$161.52
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	264	180	$94.54	$42.84
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	242	242	$308.50	$141.38
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	131	113	$94.54	$42.82
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	109	109	$308.50	$141.99
99306 Initial nursing facility visit, typically 45 minutes per day	83	83	$419.38	$193.51
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	76	69	$357.52	$165.17
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	31	31	$357.52	$164.34
99306 Initial nursing facility visit, typically 45 minutes per day	22	22	$419.38	$196.73
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	12	12	$185.40	$84.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	2,031	335	$176.97	$77.87
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	1,148	276	$253.42	$111.25
11042 Removal of skin and tissue, 20.0 sq cm or less	962	153	$340.31	$132.08
17250 Application of chemical to stop tissue regrowth in wound	816	123	$235.97	$74.52
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	703	266	$177.00	$77.42
11042 Removal of skin and tissue, 20.0 sq cm or less	480	127	$340.35	$57.39
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	455	205	$253.42	$110.96
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	441	87	$581.88	$245.83
97597 Removal of tissue from wound, 20.0 sq cm or less	366	72	$244.00	$108.34
17250 Application of chemical to stop tissue regrowth in wound	302	106	$235.97	$29.10
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	248	193	$94.65	$41.24
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	201	201	$313.27	$137.89
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	186	44	$581.83	$159.32
97598 Removal of tissue from wound, each additional 20.0 sq cm	170	11	$109.00	$47.97
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	111	101	$94.70	$41.07
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	91	91	$313.34	$138.37
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	78	71	$362.54	$159.10
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	71	71	$189.09	$83.24
99306 Initial nursing facility visit, typically 45 minutes per day	55	55	$427.43	$188.83
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	39	39	$189.48	$83.14
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	20	20	$362.00	$158.96
99306 Initial nursing facility visit, typically 45 minutes per day	17	17	$427.62	$189.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	1,424	184	$339.66	$123.57
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	1,338	272	$164.76	$72.17
17250 Application of chemical to stop tissue regrowth in wound	1,028	159	$239.76	$73.72
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	898	111	$600.90	$250.33
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	816	210	$215.06	$95.34
11042 Removal of skin and tissue, 20.0 sq cm or less	601	167	$339.66	$54.31
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	501	218	$164.76	$71.63
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	427	94	$600.90	$161.10
17250 Application of chemical to stop tissue regrowth in wound	392	116	$239.76	$26.73
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	356	153	$215.06	$94.81
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	144	113	$103.86	$45.50
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	143	143	$304.74	$133.92
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	136	107	$318.44	$140.06
99306 Initial nursing facility visit, typically 45 minutes per day	80	80	$392.04	$172.23
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	70	70	$211.56	$92.23
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	67	58	$103.86	$45.28
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	56	56	$304.74	$134.88
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	47	14	$193.60	$57.58
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	42	42	$211.56	$92.76
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	41	39	$318.44	$138.47
11044 Removal of bone, 20.0 sq cm or less	37	15	$799.78	$331.49
99306 Initial nursing facility visit, typically 45 minutes per day	21	21	$392.04	$172.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	1,506	143	$339.92	$122.07
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	1,172	268	$164.90	$73.14
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	1,105	93	$601.49	$256.25
17250 Application of chemical to stop tissue regrowth in wound	1,067	174	$240.22	$72.54
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	954	212	$215.29	$96.58
11042 Removal of skin and tissue, 20.0 sq cm or less	460	123	$339.80	$52.25
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	458	182	$164.79	$72.85
17250 Application of chemical to stop tissue regrowth in wound	361	114	$239.84	$28.10
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	358	145	$215.11	$95.99
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	356	78	$601.20	$162.52
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	156	12	$106.75	$44.23
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	137	115	$104.05	$46.51
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	130	104	$318.62	$142.61
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	117	116	$304.74	$136.36
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	92	15	$193.93	$79.43
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	81	81	$211.56	$94.26
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	63	17	$193.60	$59.46
99306 Initial nursing facility visit, typically 45 minutes per day	61	61	$392.04	$175.36
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	58	58	$304.74	$136.81
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	52	52	$103.86	$46.33
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	38	36	$318.44	$142.64
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	37	37	$211.56	$95.65
11044 Removal of bone, 20.0 sq cm or less	36	12	$799.78	$336.39
99306 Initial nursing facility visit, typically 45 minutes per day	18	18	$392.04	$176.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	1,161	145	$324.34	$108.88
17250 Application of chemical to stop tissue regrowth in wound	1,078	136	$222.79	$67.64
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	913	205	$216.44	$98.23
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	912	235	$164.38	$74.38
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	845	99	$586.58	$251.98
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	423	75	$586.77	$166.44
11042 Removal of skin and tissue, 20.0 sq cm or less	422	104	$324.12	$47.64
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	389	150	$164.34	$74.34
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	376	137	$216.48	$97.73
17250 Application of chemical to stop tissue regrowth in wound	375	91	$222.78	$26.70
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	177	153	$104.27	$47.11
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	100	100	$304.58	$138.52
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	95	83	$317.92	$143.77
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	77	72	$104.32	$47.07
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	67	66	$304.10	$138.61
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	62	13	$190.02	$81.15
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	53	53	$213.86	$96.50
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	51	16	$190.11	$60.77
99306 Initial nursing facility visit, typically 45 minutes per day	40	40	$393.52	$178.04
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	29	26	$317.92	$144.95
G0407 Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth	28	22	$184.20	$76.47
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	28	28	$213.86	$96.71
99306 Initial nursing facility visit, typically 45 minutes per day	23	23	$393.52	$177.92
G0406 Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth	16	16	$100.34	$40.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	992	230	$161.10	$72.17
11042 Removal of skin and tissue, 20.0 sq cm or less	940	102	$309.60	$105.19
17250 Application of chemical to stop tissue regrowth in wound	885	110	$210.80	$67.86
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	662	84	$565.36	$247.37
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	630	206	$213.92	$96.01
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	287	133	$161.10	$71.83
11042 Removal of skin and tissue, 20.0 sq cm or less	263	81	$309.60	$50.98
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	245	54	$565.36	$166.41
17250 Application of chemical to stop tissue regrowth in wound	187	67	$210.80	$26.51
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	178	108	$213.92	$95.87
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	161	138	$102.68	$46.24
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	156	156	$302.98	$135.90
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	102	102	$302.98	$136.31
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	67	66	$102.68	$45.89
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	52	52	$210.16	$93.80
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	34	34	$210.16	$93.92
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	19	19	$315.96	$141.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	868	206	$214.60	$96.26
11042 Removal of skin and tissue, 20.0 sq cm or less	690	76	$298.52	$113.79
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	626	194	$162.88	$73.18
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	352	63	$560.62	$245.35
17250 Application of chemical to stop tissue regrowth in wound	302	63	$208.62	$65.35
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	271	125	$214.60	$96.17
11042 Removal of skin and tissue, 20.0 sq cm or less	199	57	$298.52	$59.22
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	194	96	$162.88	$72.71
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	181	49	$560.62	$166.35
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	87	69	$104.52	$46.70
99306 Initial nursing facility visit, typically 45 minutes per day	83	83	$387.80	$175.21
99306 Initial nursing facility visit, typically 45 minutes per day	69	69	$387.80	$176.00
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	64	64	$303.72	$136.80
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	48	48	$303.72	$136.99
17250 Application of chemical to stop tissue regrowth in wound	29	17	$208.62	$28.26
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	23	23	$212.72	$95.29
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	19	19	$212.72	$95.96
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	17	11	$104.52	$46.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	148	47	$213.90	$92.50
11042 Removal of skin and tissue, 20.0 sq cm or less	85	21	$293.22	$99.40
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	60	13	$557.10	$230.96
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	59	31	$161.58	$69.88
17250 Application of chemical to stop tissue regrowth in wound	44	13	$203.52	$70.95
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	35	16	$213.90	$92.30
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	25	13	$104.32	$45.13
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	18	18	$302.24	$131.87
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	14	14	$302.24	$131.34
99306 Initial nursing facility visit, typically 45 minutes per day	11	11	$386.14	$168.04

Medical Specialties & State Licenses

CMS Verified: 2024-03-28

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License MA 272930

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Family Medicine

NUCC Taxonomy Code: 207Q00000X

State License MA 272930

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Hospital & Practice Group Affiliations

Vohra Post Acute Care Physicians Of The Northeast Pa

945 Concord St, Framingham, MA 017014613

Phone: 8778667123

Secondary Practice Locations

121 Dekalb Ave

Brooklyn, NY 112015425

Phone: 7182508000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

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Doctor of Medicine (M.D.)

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Internal Medicine - Cardiovascular Disease

NPI 1003860115

Doctor of Medicine (M.D.)

Dr. Arnold Fikkert , DO

Surgery

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Doctor of Osteopathic Medicine (D.O.)

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Family Medicine

NPI 1023078870

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 28, 2024

Surgery (License #272930 in MA)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2018

Student in an Organized Health Care Education/Training Program

✅

NPI Profile Active September 21, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location September 21, 2017

Registered at 3601 SW 160TH AVE STE 250, MIRAMAR, FL 330276314 (Tel: 8778667123)

📍

Updated Business Mailing Address September 21, 2017

Registered at 133 MALDEN ST, MALDEN, MA 021486518 (Tel: (781) 249-0303)

👤

Provider Name / Credentials Updated September 21, 2017

Recorded as EMMANUEL JACOB, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 21, 2017

Family Medicine (License #272930 in MA)

✅

NPI Profile Active May 06, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location May 06, 2015

Registered at 121 DEKALB AVE, BROOKLYN, NY 112015425 (Tel: 7182508000)

📍

Updated Business Mailing Address May 06, 2015

Registered at 133 MALDEN ST, MALDEN, MA 021486518 (Tel: 7812490303)

👤

Provider Name / Credentials Updated May 06, 2015

Recorded as EMMANUEL JACOB, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 06, 2015

Student in an Organized Health Care Education/Training Program

🟢

Initial NPI Registration & Enumeration May 06, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1902283211

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 06, 2015

Last Update: March 28, 2024

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

133 Malden St

Malden, MA 021486518

Phone: 7812490303

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.