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DR. MARIAMMA JACOB M.D
NPI 1477539567
Pediatrics in Brooklyn, NY

Active since December 20, 2005PECOS Enrolled
451 CLARKSON AVE, BROOKLYN, NY 11203(718) 245-3638 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Mariamma Jacob M.d NPPES

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

DR. MARIAMMA JACOB M.D (NPI 1477539567) is an individual pediatrics provider in Brooklyn, New York, licensed in New York (191017) and active in the NPI registry since December 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477539567
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. MARIAMMA JACOBCredential: M.D
Location Address451 CLARKSON AVEBrooklyn, NY 11203-2057
Mailing Address2 Katharina PlTownship Of Washington, NJ 07676-4125 · (201) 447-6609 · Fax (201) 447-6609
Phone(718) 245-3638
Sole ProprietorNo
Enumeration DateDecember 20, 2005
Last NPPES UpdateJuly 8, 2007
✔ NPI 1477539567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NY · 191017
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
451 CLARKSON AVE, Brooklyn, NY 11203
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mariamma Jacob M.d 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 Reassignment

Medicare enrollment records show Mariamma Jacob reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Newark Community Health Centers, Inc
13 mi
Federally Qualified Health Center (FQHC)
92-96 FERRY STREET
Newark, NJ 07105
  • Reassigned Medicare billing, New Jersey enrollment
  • 172 clinicians in this Medicare group
NPI 1366993586 (973) 483-1300

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 11203 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

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.

GEORGETTE JONES LCSW
Social Worker (Clinical)
451 CLARKSON AVE
BROOKLYN, NY 11203
Kings County (718) 245-3131
SHAYLA NICOLE REID
Obstetrics & Gynecology
451 CLARKSON AVE
BROOKLYN, NY 11203
Kings County (844) 692-4692
DR. NINAD DESAI MD
Pediatrics (Pediatric Hematology-Oncology)
451 CLARKSON AVE, KINGS COUNTY HOSPITAL CENTER; B 6202
BROOKLYN, NY 11203
Kings County (718) 245-4105
MS. BARBARA ANGELA HENDERSON RRT
General Acute Care Hospital
451 CLARKSON AVE
BROOKLYN, NY 11203
Kings County (718) 245-4526
VIKTORIYA TKACHENKO M.D.
Internal Medicine
451 CLARKSON AVE, BOX 22
BROOKLYN, NY 11203
Kings County (718) 245-2237
LANCE WINSLOW PSYD
Psychologist
451 CLARKSON AVE
BROOKLYN, NY 11203
Kings County (718) 245-1162
LYDIE KOHLER MCKENZIE MD
Emergency Medicine
451 CLARKSON AVE
BROOKLYN, NY 11203
Kings County (718) 245-4616
LEELA VENKAT MD
Anesthesiology
451 CLARKSON AVE
BROOKLYN, NY 11203
Kings County (718) 245-4408

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 Mariamma Jacob's NPI number?

The NPI number for Mariamma Jacob is 1477539567. It was assigned to this individual provider in the NPPES registry on December 20, 2005.

Where is Mariamma Jacob located?

Mariamma Jacob practices at 451 Clarkson Ave, Brooklyn, NY 11203. The listed phone number is (718) 245-3638.

What is Mariamma Jacob's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mariamma Jacob enrolled in Medicare?

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

Which organization bills Medicare for Mariamma Jacob's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mariamma Jacob reassigns Medicare benefits to Newark Community Health Centers, Inc (Newark, NJ). 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 Mariamma Jacob'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 Mariamma Jacob was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.