DR. JACOB TIANGE LU MD
NPI 1093371551
Internal Medicine - Critical Care Medicine in Staten Island, NY

Q: What is Jacob Lu's NPI number?

The NPI number for Jacob Lu is 1093371551. It was assigned to this individual provider in the NPPES registry on May 10, 2019.

Q: What is Jacob Lu's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Lu was last updated on July 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.

Active since May 10, 2019PECOS EnrolledAccepts Medicare Assignment

475 SEAVIEW AVE, STATEN ISLAND, NY 10305(718) 226-8630 Get Directions Write a Review

NPPES record last updated: July 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 11, 2025, May 10, 2019 (2 updates tracked since 2019).

On this page

About Dr. Jacob Tiange Lu Md NPPES

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

DR. JACOB TIANGE LU MD (NPI 1093371551) is an individual critical care medicine provider in Staten Island, New York, licensed in New Jersey (25MA12589100) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, is affiliated with Newark Beth Israel Medical Center, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1093371551

Entity TypeIndividualMale

Primary Taxonomy207RC0200X

Provider Legal NameDR. JACOB TIANGE LUCredential: MD

Location Address475 SEAVIEW AVEStaten Island, NY 10305-3436

Mailing Address475 Seaview AveStaten Island, NY 10305-3436 · (718) 226-8630

Phone(718) 226-8630

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateMay 10, 2019

Last NPPES UpdateJuly 11, 20252 updates tracked since enumeration

NPPES CertifiedJuly 11, 2025

✔ NPI 1093371551 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RC0200X

License✔ Licensed in NJ · 25MA12589100

Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

475 SEAVIEW AVE, Staten Island, NY 10305

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jacob Tiange Lu Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436489275

PECOS Enrollment IDI20250729000025

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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Newark Beth Israel Medical Center

Acute Care Hospitals · Newark, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310002

Location201 Lyons AveNewark, NJ 07112 · Essex County

Emergency services Birthing friendly

Robert Wood Johnson University Hospital At Rahway

Acute Care Hospitals · Rahway, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310024

Location865 Stone StRahway, NJ 07065 · Union County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10305 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

$154.28 typical visit price

range $67.40 – $203.53

Typical copayment $38.57 (range $16.85 – $50.88)

Most-billed visit code 99204

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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. DAWN MARIE COTTONE RPA-C

Physician Assistant (Surgical)