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JESU JACOB, D.O., P.C.
NPI 1457630899
Orthopaedic Surgery - Sports Medicine in Commack, NY

Active since August 16, 2011
66 HARNED RD, COMMACK, NY 11725(631) 670-7800(631) 670-7798 Get Directions Write a Review

NPPES record last updated: March 3, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jesu Jacob, D.o., P.c. NPPES

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

JESU JACOB, D.O., P.C. (NPI 1457630899) is a healthcare organization registered as a sports medicine in Commack, New York and active in the NPI registry since August 2011. The organization lists Jesu Jacob, Owner/ Ceo, as its authorized official.

NPPES Registry Identity

NPI1457630899
Entity TypeOrganization
Primary Taxonomy207XX0005X
Legal Business NameJESU JACOB, D.O., P.C.
Location Address66 HARNED RDCommack, NY 11725-3527
Mailing Address66 Harned RdCommack, NY 11725-3527 · (631) 670-7800 · Fax (631) 670-7798
Phone(631) 670-7800
Fax(631) 670-7798
Organization SubpartNo
Authorized OfficialJesu JacobOwner/ Ceo · (631) 670-7800
Enumeration DateAugust 16, 2011
Last NPPES UpdateMarch 3, 2016
✔ NPI 1457630899 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
License✔ Licensed in NY · 235713
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
66 HARNED RD, Commack, NY 11725
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jesu Jacob, D.o., P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNew YorkEnrollment IDO20111004000564Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jesu Jacob, D.O., P.C., which bills Medicare for the services this clinician delivers.

Clinician (1)

Jesu Jacob, D.O.
Orthopedic Surgery
NPI 1194990895
66 HARNED RD
Commack, NY 11725
(631) 670-7800
✔ PECOS✔ Accepts MedicareSame address

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

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 Jesu Jacob, D.O., P.C.'s NPI number?

The NPI number for Jesu Jacob, D.O., P.C. is 1457630899. It was assigned to this organization in the NPPES registry on August 16, 2011.

Where is Jesu Jacob, D.O., P.C. located?

Jesu Jacob, D.O., P.C. is located at 66 Harned Rd, Commack, NY 11725. The listed phone number is (631) 670-7800.

What is Jesu Jacob, D.O., P.C.'s specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Jesu Jacob, D.O., P.C. enrolled in Medicare?

Yes. Jesu Jacob, D.O., P.C. is registered in the Medicare PECOS enrollment system.

When is Jesu Jacob, D.O., P.C.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Jesu Jacob, D.O., P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Orthopedic Surgery) reassigns their Medicare billing to Jesu Jacob, D.O., P.C.. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jesu Jacob, D.O., P.C. was last updated on March 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.