DR. TED VICTOR JACOBY MD - NPI 1306520374 - Student in an Organized Health Care Education/Training Program in Sacramento, CA

Q: What is Ted Jacoby's NPI number?

The NPI number for Ted Jacoby is 1306520374. It was assigned to this individual provider in the NPPES registry on June 12, 2023.

Q: What is Ted Jacoby's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Ted Jacoby was last updated on June 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

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About Dr. Ted Victor Jacoby Md NPPES

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

DR. TED VICTOR JACOBY MD (NPI 1306520374) is an individual student in an organized health care education/training program in Sacramento, California, licensed in Hawaii (MDR-8540) and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS and maintains a secondary practice location in Honolulu.

NPPES Registry Identity

NPI1306520374

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. TED VICTOR JACOBYCredential: MD

Location Address3301 C ST STE 1400Sacramento, CA 95816-3367

Mailing Address3301 C St Ste 1400Sacramento, CA 95816-3367

Phone(916) 551-2627

Sole ProprietorNo

Enumeration DateJune 12, 2023

Last NPPES UpdateJune 25, 20242 updates tracked since enumeration

NPPES CertifiedJune 25, 2024

✔ NPI 1306520374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in HI · MDR-8540

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.

Also ListedInternal MedicineTaxonomy 207R00000X · License MDR-8520 (HI)

3301 C ST STE 1400, Sacramento, CA 95816

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Secondary Practice Location 1

Location 11356 Lusitana St Fl 7Honolulu, HI 96813-2409 · Phone (808) 586-2898

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. Ted Victor Jacoby Md 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 16

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

STEPHANIE T LE MD

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