DR. TED VICTOR JACOBY MD
NPI 1306520374
Student in an Organized Health Care Education/Training Program in Sacramento, CA
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, maintains a secondary practice location in Honolulu, and is a graduate of University Of Hawaii John A. Burns School Of Medicine (2023).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Ted Victor Jacoby Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Ted Jacoby reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Stockton, CA 95210
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 13
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SACRAMENTO, CA 95816
SACRAMENTO, CA 95816
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 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.
Where is Ted Jacoby located?
Ted Jacoby practices at 3301 C St Ste 1400, Sacramento, CA 95816. The listed phone number is (916) 551-2627.
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.
Is Ted Jacoby enrolled in Medicare?
Yes. Ted Jacoby is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Ted Jacoby's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ted Jacoby reassigns Medicare benefits to Permanente Medical Group Inc (Stockton, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ted Jacoby's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
# Dr. Ted Victor Jacoby, MD · NPI 1306520374
Student in an Organized Health Care Education/Training Program provider in Sacramento, California. Individual provider, active in the CMS NPPES registry since June 12, 2023.
## Identity
- **NPI:** 1306520374 (Entity type: Individual)
- **Enumerated:** June 12, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **State license:** MDR-8540 (Hawaii)
- **Sole proprietor:** No
## Practice location
- **Address:** 3301 C ST STE 1400, Sacramento, CA 95816-3367
- **Phone:** (916) 551-2627
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Permanente Medical Group Inc (NPI 1548343510, Stockton, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Hawaii John A. Burns School Of Medicine, class of 2023
## Record status
- **NPPES last updated:** June 25, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1306520374) · Data from the CMS NPPES public registry.