JAISY JACOB
NPI 1639468614
Radiology - Diagnostic Radiology in Detroit, MI

NPI Status: Active since March 30, 2011

Contact Information

4100 JOHN R ST
DETROIT, MI
ZIP 48201
Phone: (313) 576-9900

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  • Individual
  • Female
  • Years of Experience 15
  • Radiology
  • Diagnostic Radiology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JAISY JACOB

This page provides the complete NPI Profile along with additional information for Jaisy Jacob, a provider established in Detroit, Michigan with a medical specialization in Radiology, focusing in diagnostic radiology and more than 15 years of experience. The healthcare provider is registered in the NPI registry with number 1639468614 assigned on March 2011. The practitioner's primary taxonomy code is 2085R0202X with license number 4301107800 (MI). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1639468614
Provider Name
JAISY JACOB
Gender
Female
Entity Type
Individual
Location Address
4100 JOHN R ST DETROIT, MI 48201
Location Phone
(313) 576-9900
Mailing Address
4100 JOHN R ST DETROIT, MI 48201
Mailing Phone
(313) 576-9900
Medical School Name
OTHER
Graduation Year
2011
Is Sole Proprietor?
No
Enumeration Date
03-30-2011
Last Update Date
05-13-2022
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Location Map

Secondary Locations

  • 3601 W 13 Mile Rd
    Royal Oak, MI 48073
    (248) 898-6031

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Radiology Diagnostic Radiology

Taxonomy Code
2085R0202X
Type
Allopathic & Osteopathic Physicians
License No.
4301107800
License State
MI
Taxonomy Description
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
12085B0100XAllopathic & Osteopathic Physicians

Radiology
Body Imaging

4301107800 (MI)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Cross� Preferred HMO Bronze Extra - HMO
  • Blue Cross� Preferred HMO Bronze Saver HSA - HMO
  • Blue Cross� Preferred HMO Bronze Secure - HMO
  • Blue Cross� Preferred HMO Gold - HMO
  • Blue Cross� Preferred HMO Gold Extra - HMO
  • Blue Cross� Preferred HMO Silver - HMO
  • Blue Cross� Preferred HMO Silver Extra - HMO
  • Blue Cross� Preferred HMO Silver Saver - HMO
  • Blue Cross� Preferred HMO Value - HMO
  • Blue Cross� Select HMO Bronze Extra - HMO
  • Blue Cross� Select HMO Bronze Saver HSA - HMO
  • Blue Cross� Select HMO Bronze Secure - HMO
  • Blue Cross� Select HMO Silver - HMO
  • Blue Cross� Select HMO Silver Extra - HMO
  • Blue Cross� Select HMO Silver Saver - HMO
  • Blue Cross� Select HMO Value - HMO
  • Blue Cross� Premier PPO Bronze Extra - PPO
  • Blue Cross� Premier PPO Bronze Saver HSA - PPO
  • Blue Cross� Premier PPO Bronze Secure - PPO
  • Blue Cross� Premier PPO Gold - PPO
  • Blue Cross� Premier PPO Gold Extra - PPO
  • Blue Cross� Premier PPO Silver - PPO
  • Blue Cross� Premier PPO Silver Extra - PPO
  • Blue Cross� Premier PPO Silver Saver HSA - PPO
  • Blue Cross� Premier PPO Value - PPO
  • MyPriority Balanced Silver - HMO
  • MyPriority Balanced Silver Southeast Michigan Network - HMO
  • MyPriority Enhanced Gold Southeast Michigan Network - HMO
  • MyPriority Premier Silver - HMO
  • MyPriority Standard Bronze - HMO
  • MyPriority Standard Bronze - Southeast Michigan Network - HMO
  • MyPriority Standard Bronze - Travel - HMO
  • MyPriority Standard Gold - HMO
  • MyPriority Standard Gold Southeast Michigan Network - HMO
  • MyPriority Standard Silver - HMO
  • MyPriority Standard Silver - Southeast Michigan Network - HMO
  • MyPriority Standard Silver - Travel - HMO
  • MyPriority Value Bronze - HMO
  • MyPriority Value Bronze HSA - HMO
  • MyPriority Value Bronze HSA Southeast Michigan Network - HMO
  • MyPriority Value Bronze Southeast Michigan Network - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Jaisy Jacob is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jaisy Jacob is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2466765276

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20180822001806

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Biopsy of breast and placement of locating device using ultrasound, first growth

A breast biopsy with locating device placement involves taking a small sample from an unusual growth, using ultrasound for precise targeting. This sample is studied for any abnormal cells. A locating device is also placed to mark the area for future reference.

This service was performed 14 times for 14 patients

Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)

Diagnostic digital breast tomosynthesis is a 3D imaging test that allows doctors to examine your breast tissue layer by layer. It's performed on one or both sides. It helps in detecting abnormalities more accurately. It's often done in addition to other tests.

This service was performed 19 times for 19 patients

Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)

Diagnostic digital breast tomosynthesis is a 3D imaging test that allows doctors to examine your breast tissue layer by layer. It's performed on one or both sides. It helps in detecting abnormalities more accurately. It's often done in addition to other tests.

This service was performed 74 times for 72 patients

Diagnostic mammography of 1 breast

Diagnostic mammography of 1 breast is a detailed imaging test that allows doctors to closely examine a specific area in the breast. It's often used when a routine screening reveals an abnormality. This test can help identify any unusual changes or issues.

This service was performed 25 times for 25 patients

Diagnostic mammography of 1 breast

Diagnostic mammography of 1 breast is a detailed imaging test that allows doctors to closely examine a specific area in the breast. It's often used when a routine screening reveals an abnormality. This test can help identify any unusual changes or issues.

This service was performed 75 times for 69 patients

Diagnostic mammography of both breasts

Diagnostic mammography involves using special imaging technology to capture detailed images of both breasts. This procedure helps in identifying any unusual changes or abnormalities. It's a crucial step in ensuring breast health and early detection of potential issues.

This service was performed 18 times for 18 patients

Diagnostic mammography of both breasts

Diagnostic mammography involves using special imaging technology to capture detailed images of both breasts. This procedure helps in identifying any unusual changes or abnormalities. It's a crucial step in ensuring breast health and early detection of potential issues.

This service was performed 32 times for 32 patients

Limited ultrasound scan of 1 breast

A limited ultrasound scan of one breast is a non-invasive imaging test. It uses sound waves to create pictures of the inside of your breast. It helps identify any unusual growths or changes. It's safe, quick, and typically painless.

This service was performed 33 times for 33 patients

Limited ultrasound scan of 1 breast

A limited ultrasound scan of one breast is a non-invasive imaging test. It uses sound waves to create pictures of the inside of your breast. It helps identify any unusual growths or changes. It's safe, quick, and typically painless.

This service was performed 75 times for 74 patients

Screening 3d breast mammography

Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.

This service was performed 140 times for 140 patients

Screening 3d breast mammography

Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.

This service was performed 108 times for 108 patients

Screening mammography

Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.

This service was performed 232 times for 232 patients

Screening mammography

Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.

This service was performed 221 times for 221 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $22.69 for a new patient copayment and $18.09 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 48201 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $90.76
  • Minimum New Patient Price $58.04
  • Maximum New Patient Price $177.36
  • Average New Patient Copayment $22.69
  • Minimum New Patient Copayment $14.51
  • Maximum New Patient Copayment $44.34

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $72.38
  • Minimum Established Patient Price $18.32
  • Maximum Established Patient Price $143.49
  • Average Established Patient Copayment $18.09
  • Minimum Established Patient Copayment $4.58
  • Maximum Established Patient Copayment $35.87

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jaisy Jacob is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
HENRY FORD MACOMB HOSPITAL15855 NINETEEN MILE RD
CLINTON TOWNSHIP, MI 48038
(586) 263-2300Acute Care Hospitals
HENRY FORD HEALTH HOSPITAL2799 W GRAND BLVD
DETROIT, MI 48202
(313) 916-2600Acute Care Hospitals
HENRY FORD HEALTH WYANDOTTE HOSPITAL2333 BIDDLE AVE
WYANDOTTE, MI 48192
(734) 246-6000Acute Care Hospitals
HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL6777 WEST MAPLE ROAD
WEST BLOOMFIELD, MI 48322
(248) 325-1000Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1639468614, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 76. The final step is to find the difference between that total and the next multiple of ten (80 - 76 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
3
Doubled → 6
Pos 4
9
Unchanged
Pos 5
4
Doubled → 8
Pos 6
6
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
6
Unchanged
Pos 9
1
Doubled → 2
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 4 → 8 8 → 16 → 7 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 6 + 9 + 8 + 6 + 1 + 6 + 6 + 2 + 24 = 76

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 76 is 80. The difference is the calculated check digit.

80 - 76 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1639468614.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Radiology (Radiation Oncology)
4100 JOHN R ST
DETROIT, MI 48201
Nurse Practitioner (Adult Health)
4100 JOHN R ST
DETROIT, MI 48201
Nurse Practitioner (Adult Health)
4100 JOHN R ST, WALT CBC KARMANOS CC
DETROIT, MI 48201
Pharmacist (Pharmacotherapy)
4100 JOHN R ST
DETROIT, MI 48201
Nurse Practitioner
4100 JOHN R ST
DETROIT, MI 48201
Pharmacist (Pharmacotherapy)
4100 JOHN R ST, PHARMACY DEPARTMENT
DETROIT, MI 48201
Nurse Practitioner
4100 JOHN R ST
DETROIT, MI 48201
Nurse Practitioner
4100 JOHN R ST
DETROIT, MI 48201
Radiology (Neuroradiology)
4100 JOHN R ST, MAILCODE HP07ID
DETROIT, MI 48201
Pharmacist (Oncology)
4100 JOHN R ST
DETROIT, MI 48201
Pharmacist
4100 JOHN R ST
DETROIT, MI 48201
Internal Medicine (Medical Oncology)
4100 JOHN R ST
DETROIT, MI 48201
Pharmacist (Oncology)
4100 JOHN R ST
DETROIT, MI 48201
Pharmacist (Pharmacotherapy)
4100 JOHN R ST, PHARMACY DEPARTMENT
DETROIT, MI 48201
Internal Medicine (Hematology & Oncology)
4100 JOHN R ST, HW04HO
DETROIT, MI 48201
Pharmacist (Oncology)
4100 JOHN R ST
DETROIT, MI 48201
Physician Assistant
4100 JOHN R ST
DETROIT, MI 48201
Nurse Practitioner
4100 JOHN R ST
DETROIT, MI 48201
Nurse Practitioner
4100 JOHN R ST
DETROIT, MI 48201
Registered Nurse (Psychiatric/Mental Health, Adult)
4100 JOHN R ST, WEO1PF
DETROIT, MI 48201

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639468614, enumerated as an "individual" on March 30, 2011.

The provider is located at 4100 JOHN R ST DETROIT, MI 48201 and the phone number is (313) 576-9900.

Radiology with taxonomy code 2085R0202X and a focus in Diagnostic Radiology.

The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.

Jaisy Jacob is affiliated with: HENRY FORD MACOMB HOSPITAL, HENRY FORD HEALTH HOSPITAL, HENRY FORD HEALTH WYANDOTTE HOSPITAL and HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL.