BONNIE JACOBS PHD
NPI 1225169493
Psychologist in Manorville, NY

Active since March 08, 2007PECOS Enrolled
15 EVERGREEN DR, MANORVILLE, NY 11949(631) 444-2938 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Bonnie Jacobs Phd NPPES

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

BONNIE JACOBS PHD (NPI 1225169493) is an individual psychologist in Manorville, New York, licensed in New York (010569) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1989).

NPPES Registry Identity

NPI1225169493
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameBONNIE JACOBSCredential: PHD
Location Address15 EVERGREEN DRManorville, NY 11949-3215
Mailing AddressPo Box 826East Setauket, NY 11733-0636 · (631) 444-2938
Sole ProprietorNo
Medical School CMSOtherGraduated 1989
Enumeration DateMarch 8, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1225169493 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in NY · 010569
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
15 EVERGREEN DR, Manorville, NY 11949

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bonnie Jacobs Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2567536998
PECOS Enrollment IDI20080804000369
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.

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 Bonnie Jacobs's NPI number?

The NPI number for Bonnie Jacobs is 1225169493. It was assigned to this individual provider in the NPPES registry on March 8, 2007.

Where is Bonnie Jacobs located?

Bonnie Jacobs practices at 15 Evergreen Dr, Manorville, NY 11949. The listed phone number is (631) 444-2938.

What is Bonnie Jacobs's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Bonnie Jacobs enrolled in Medicare?

Yes. Bonnie Jacobs is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bonnie Jacobs was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.