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LISA SUSAN JACOB D.D.S.
NPI 1386688331
Dentist - Pediatric Dentistry in Kyle, TX

Active since June 16, 2006PECOS Enrolled
2810 DACY LN, KYLE, TX 78640(210) 233-7000(512) 268-2253 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Lisa Susan Jacob D.d.s. NPPES

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

LISA SUSAN JACOB D.D.S. (NPI 1386688331) is an individual pediatric dentistry provider in Kyle, Texas, licensed in Texas (19077) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Austin.

NPPES Registry Identity

NPI1386688331
Entity TypeIndividualFemale
Primary Taxonomy1223P0221X
Provider Legal NameLISA SUSAN JACOBCredential: D.D.S.
Location Address2810 DACY LNKyle, TX 78640-6322
Mailing Address1301 Barbara Jordan Blvd Ste 301Austin, TX 78723-3078 · (512) 324-9999 · Fax (512) 324-0645
Phone(210) 233-7000
Fax(512) 268-2253
Sole ProprietorNo
Enumeration DateJune 16, 2006
Last NPPES UpdateSeptember 11, 2025
NPPES CertifiedSeptember 11, 2025
✔ NPI 1386688331 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in TX · 19077
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Also ListedDentistTaxonomy 122300000X · License 19077 (TX)
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License 19077 (TX)
2810 DACY LN, Kyle, TX 78640
Open in Google Maps ↗

Secondary Practice Location 1

Location 11301 Barbara Jordan Blvd, Suite 307Austin, TX 78723-3077 · Phone (512) 324-9999 ext. 87141 · Fax (512) 324-0645

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Susan Jacob D.d.s. 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Lisa Jacob reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Barrio Comprehensive Family Health Care Center, Inc.
Same address
Federally Qualified Health Center (FQHC)
2810 DACY LANE
Kyle, TX 78640
  • Reassigned Medicare billing, Texas enrollment
  • 268 clinicians in this Medicare group
NPI 1003136912 (512) 268-8900
Dell Children's Medical Group
22 mi
Pediatrics
1301 BARBARA JORDAN BLVD STE 200
Austin, TX 78723
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Dell Childrens Medical Group
  • 576 clinicians in this Medicare group
NPI 1326072943 (512) 628-1800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78640 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

CHRISTOPHER R HASTINGS D.D.S.
Dentist (General Practice)
2810 DACY LN
KYLE, TX 78640
Hays County (512) 268-8900
ANUSHA KOTHA DDS
Dentist (General Practice)
2810 DACY LN
KYLE, TX 78640
Hays County (210) 233-7000
KAYLA MERRITT
Nurse Practitioner (Women's Health)
2810 DACY LN
KYLE, TX 78640
Hays County (512) 268-8900
MAGDALENE ANNA ROZMIAREK NP
Nurse Practitioner (Psychiatric/Mental Health)
2810 DACY LN
KYLE, TX 78640
Hays County (512) 268-8900
DR. JAMES HAO WANG M.D.
Family Medicine
2810 DACY LN
KYLE, TX 78640
Hays County (512) 268-8900
NATHANIEL WREN MORGAN LPC
Counselor (Professional)
2810 DACY LN
KYLE, TX 78640
Hays County (512) 268-8900
ELEANOR KAURA
Nurse Practitioner (Women's Health)
2810 DACY LN
KYLE, TX 78640
Hays County (512) 268-8900
GABRIELA T. MORA LPC
Counselor (Professional)
2810 DACY LN
KYLE, TX 78640
Hays County (512) 268-8900

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 Lisa Jacob's NPI number?

The NPI number for Lisa Jacob is 1386688331. It was assigned to this individual provider in the NPPES registry on June 16, 2006.

Where is Lisa Jacob located?

Lisa Jacob practices at 2810 Dacy Ln, Kyle, TX 78640. The listed phone number is (210) 233-7000.

What is Lisa Jacob's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Is Lisa Jacob enrolled in Medicare?

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

Which organizations bill Medicare for Lisa Jacob's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Jacob reassigns Medicare benefits to 2 organizations: Barrio Comprehensive Family Health Care Center, Inc. (Kyle, TX) and Dell Children's Medical Group (Austin, TX). Each 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 Lisa Jacob's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Jacob accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 11 other insurers list Lisa 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 Lisa Jacob was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.