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JACOB ITSKOVICH DMD
NPI 1194350140
Student in an Organized Health Care Education/Training Program in Farmington, CT

Active since March 10, 2020PECOS Enrolled
263 FARMINGTON AVE, FARMINGTON, CT 06030(860) 679-2000 Get Directions Write a Review

NPPES record last updated: August 4, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 4, 2020, May 26, 2020, Mar 10, 2020 (3 updates tracked since 2020).

About Jacob Itskovich Dmd NPPES

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

JACOB ITSKOVICH DMD (NPI 1194350140) is an individual student in an organized health care education/training program in Farmington, Connecticut, licensed in Connecticut (12877) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194350140
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACOB ITSKOVICHCredential: DMD
Location Address263 FARMINGTON AVEFarmington, CT 06030-0001
Mailing Address6855 Leytonstone BlvdWest Bloomfield, MI 48322-1243 · (248) 303-5919
Phone(860) 679-2000
Sole ProprietorNo
Enumeration DateMarch 10, 2020
Last NPPES UpdateAugust 4, 20203 updates tracked since enumeration
NPPES CertifiedAugust 4, 2020
✔ NPI 1194350140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in CT · 12877
Definition
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.
263 FARMINGTON AVE, Farmington, CT 06030
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma 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)

Jacob Itskovich 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.

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.

STATE OF CONNECTICUT HEALTH CENTER
Pathology (Anatomic Pathology & Clinical Pathology)
263 FARMINGTON AVE, LABORATORY HBP GROUP
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-7503
MR. IAN THOMAS MCNEILL
Neurological Surgery
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-8080
DR. LUIS CHAVEZ DE PAZ DDS, MS, PHD
Dentist (Endodontics)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-2719
TARUNYA REDDY VEDERE
Internal Medicine (Endocrinology, Diabetes & Metabolism)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3245
ZACHARY TALLENT SOLOMON
Surgery
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3467
MICHAEL CONNOLLY
Psychiatry & Neurology (Psychiatry)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-4733
EMILY WENG DO
Internal Medicine (Gastroenterology)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3158
ANDREW KEMERLEY DO
Student in an Organized Health Care Education/Training Program
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3467

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 Jacob Itskovich's NPI number?

The NPI number for Jacob Itskovich is 1194350140. It was assigned to this individual provider in the NPPES registry on March 10, 2020.

Where is Jacob Itskovich located?

Jacob Itskovich practices at 263 Farmington Ave, Farmington, CT 06030. The listed phone number is (860) 679-2000.

What is Jacob Itskovich's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jacob Itskovich enrolled in Medicare?

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

What insurance does Jacob Itskovich accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Guardian and 2 other insurers list Jacob Itskovich 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 Jacob Itskovich was last updated on August 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.