DR. MARY JACOB DMD
NPI 1124537667
Dentist - General Practice in Revere, MA

Q: What is Mary Jacob's NPI number?

The NPI number for Mary Jacob is 1124537667. It was assigned to this individual provider in the NPPES registry on September 27, 2017.

Q: What is Mary Jacob's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Mary Jacob was last updated on September 27, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since September 27, 2017PECOS Enrolled

334 BROADWAY, REVERE, MA 02151(178) 162-9624 Get Directions Write a Review

NPPES record last updated: September 27, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Mary Jacob Dmd NPPES

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

DR. MARY JACOB DMD (NPI 1124537667) is an individual general practice provider in Revere, Massachusetts, licensed in Massachusetts (DN1857754) and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124537667

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. MARY JACOBCredential: DMD

Location Address334 BROADWAYRevere, MA 02151-5016

Mailing Address99 Florence Street, Apt 102Malden, MA 02148 · (203) 548-1113

Phone(178) 162-9624

Sole ProprietorYes

Enumeration DateSeptember 27, 2017

✔ NPI 1124537667 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MA · DN1857754

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

334 BROADWAY, Revere, MA 02151

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, BEST Life and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mary Jacob Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 02151 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

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$78.84 typical visit price

range $21.07 – $155.29

Typical copayment $19.71 (range $5.26 – $38.82)

Most-billed visit code 99213

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 Mary Jacob's NPI number?

The NPI number for Mary Jacob is 1124537667. It was assigned to this individual provider in the NPPES registry on September 27, 2017.

Where is Mary Jacob located?

Mary Jacob practices at 334 Broadway, Revere, MA 02151. The listed phone number is (178) 162-9624.

What is Mary Jacob's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Mary Jacob enrolled in Medicare?

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

What insurance does Mary Jacob accept?

Health plans from Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 6 other insurers list Mary Jacob as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Jacob was last updated on September 27, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.