SUSAN JACOB NP
NPI 1306315130
Nurse Practitioner - Psychiatric/Mental Health in Dallas, TX

Active since November 22, 2018PECOS EnrolledAccepts Medicare Assignment
81.16/100
CMS Quality Rating
4645 SAMUELL BLVD, DALLAS, TX 75228(214) 743-1200 Get Directions Write a Review

NPPES record last updated: December 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 8, 2025, May 2, 2023, May 20, 2022 and 6 more (9 updates tracked since 2018).

About Susan Jacob Np NPPES

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

SUSAN JACOB NP (NPI 1306315130) is an individual psychiatric/mental health provider in Dallas, Texas, licensed in Texas (AP139784) and active in the NPI registry since November 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1306315130
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameSUSAN JACOBCredential: NP
Location Address4645 SAMUELL BLVDDallas, TX 75228-6826
Mailing Address1345 River Bend Dr Ste 200Dallas, TX 75247-6945
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateNovember 22, 2018
Last NPPES UpdateDecember 8, 20259 updates tracked since enumeration
NPPES CertifiedDecember 8, 2025
NPI 1306315130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in TX · AP139784
4645 SAMUELL BLVD, Dallas, TX 75228

Accepted Insurance

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

Susan Jacob Np 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 ID3971841180
PECOS Enrollment IDI20190214000132
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
90 services67 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
42 services35 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75228 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
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$100.80 typical visit price
range $18.48 – $141.20
Typical copayment $25.20 (range $4.62 – $35.30)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.16/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality63.05
Promoting Interoperability49
Improvement Activities40
Cost100

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.

Counselor (Mental Health)
4645 SAMUELL BLVD
DALLAS, TX 75228
Nurse Practitioner
4645 SAMUELL BLVD
DALLAS, TX 75228
Registered Nurse (Psychiatric/Mental Health)
4645 SAMUELL BLVD
DALLAS, TX 75228
Pharmacist
4645 SAMUELL BLVD
DALLAS, TX 75228
Nurse Practitioner (Psychiatric/Mental Health)
4645 SAMUELL BLVD
DALLAS, TX 75228
Counselor
4645 SAMUELL BLVD
DALLAS, TX 75228
Counselor (Addiction (Substance Use Disorder))
4645 SAMUELL BLVD
DALLAS, TX 75228
Counselor (Professional)
4645 SAMUELL BLVD
DALLAS, TX 75228

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 Susan Jacob's NPI number?

The NPI number for Susan Jacob is 1306315130. It was assigned to this individual provider in the NPPES registry on November 22, 2018.

Where is Susan Jacob located?

Susan Jacob practices at 4645 Samuell Blvd, Dallas, TX 75228. The listed phone number is (214) 743-1200.

What is Susan Jacob's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Susan Jacob enrolled in Medicare?

Yes. Susan Jacob is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Susan Jacob accept?

Health plans from Blue Cross and Blue Shield of Texas, Molina Healthcare and Oscar Insurance Company list Susan 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 Susan Jacob was last updated on December 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.