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MRS. MINI JOHN JACOB NURSE PRACTITIONER
NPI 1073032322
Nurse Practitioner - Family in New Hyde Park, NY

Active since September 18, 2017PECOS Enrolled
705 N 5TH ST, NEW HYDE PARK, NY 11040(516) 358-5038 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Sep 18, 2017 (2 updates tracked since 2017).

About Mrs. Mini John Jacob Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MINI JOHN JACOB NURSE PRACTITIONER (NPI 1073032322) is an individual family provider in New Hyde Park, New York, licensed in New York (F341923) and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1073032322
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. MINI JOHN JACOBCredential: NURSE PRACTITIONER
Location Address705 N 5TH STNew Hyde Park, NY 11040-2931
Mailing Address705 N 5th StNew Hyde Park, NY 11040-2931 · (516) 358-5038
Phone(516) 358-5038
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateSeptember 18, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1073032322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · F341923
705 N 5TH ST, New Hyde Park, NY 11040
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Mini John Jacob Nurse Practitioner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2062769052
PECOS Enrollment IDI20260219002718
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11040 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mini Jacob's NPI number?

The NPI number for Mini Jacob is 1073032322. It was assigned to this individual provider in the NPPES registry on September 18, 2017.

Where is Mini Jacob located?

Mini Jacob practices at 705 N 5th St, New Hyde Park, NY 11040. The listed phone number is (516) 358-5038.

What is Mini Jacob's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mini Jacob enrolled in Medicare?

Yes. Mini Jacob is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mini Jacob was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.