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DR. ISA MULINGBAYAN JACOBA MD
NPI 1720668064
Pathology - Anatomic Pathology & Clinical Pathology in Providence, RI

Active since April 12, 2021PECOS Enrolled
593 EDDY ST, PROVIDENCE, RI 02903(401) 444-5057(401) 444-8514 Get Directions Write a Review

NPPES record last updated: June 17, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 30, 2021, Apr 12, 2021 (2 updates tracked since 2021).

About Dr. Isa Mulingbayan Jacoba Md NPPES

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

DR. ISA MULINGBAYAN JACOBA MD (NPI 1720668064) is an individual anatomic pathology & clinical pathology provider in Providence, Rhode Island, licensed in Rhode Island (MD20614) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1720668064
Entity TypeIndividualFemale
Primary Taxonomy207ZP0102X
Provider Legal NameDR. ISA MULINGBAYAN JACOBACredential: MD
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing Address15 La Salle SqProvidence, RI 02903-1814 · (401) 444-6779 · Fax (401) 444-6912
Phone(401) 444-5057
Fax(401) 444-8514
Sole ProprietorNo
Enumeration DateApril 12, 2021
Last NPPES UpdateJune 17, 20262 updates tracked since enumeration
NPPES CertifiedJune 17, 2026
✔ NPI 1720668064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
Licenses✔ Licensed in RI · MD20614✔ Licensed in MA · 1021467
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
593 EDDY ST, Providence, RI 02903
Open in Google Maps ↗

Secondary Practice Locations 4

Location 1795 Middle StFall River, MA 02721-1733 · Phone (508) 996-3991 · Fax (508) 999-9442
Location 211 Friendship StNewport, RI 02840-2209 · Phone (401) 444-5057 · Fax (401) 444-8514
Location 3164 Summit AveProvidence, RI 02906-2853 · Phone (401) 444-5057 · Fax (401) 444-8514
Location 4825 Chalkstone AveProvidence, RI 02908-4728 · Phone (401) 456-2109

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Isa Mulingbayan Jacoba Md 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

6

Medicare enrollment records show Isa Jacoba reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lifespan Physician Group, Inc.
Same address
General Practice
593 EDDY ST
Providence, RI 02903
  • Reassigned Medicare billing, Rhode Island enrollment
  • 1,372 clinicians in this Medicare group
NPI 1407116643 (401) 444-6779
Rhode Island Hospital
Same address
Multi-Specialty
593 EDDY ST
Providence, RI 02903
  • Reassigned Medicare billing, Rhode Island enrollment
  • 358 clinicians in this Medicare group
NPI 1154537520 (401) 444-6905
University Pathologists, LLC
2.1 mi
Anatomic Pathology
825 CHALKSTONE AVE, RWMC - PATHOLOGY DEPARTMENT
Providence, RI 02908
  • Reassigned Medicare billing, Massachusetts and Rhode Island enrollments
  • 28 clinicians in this Medicare group
NPI 1568640886 (401) 456-2662
The Miriam Hospital
2.8 mi
Multi-Specialty
164 SUMMIT AVE
Providence, RI 02906
  • Reassigned Medicare billing, Rhode Island enrollment
  • 93 clinicians in this Medicare group
NPI 1598978744 (401) 444-5640
Lifespan Physician Group Of Massachusetts Inc
18 mi
Family Medicine
2007 BAY ST
Taunton, MA 02780
  • Reassigned Medicare billing, Massachusetts enrollment
  • 547 clinicians in this Medicare group
NPI 1235957713 (774) 409-2009
Newport Hospital
22 mi
Obstetrics & Gynecology
11 FRIENDSHIP ST
Newport, RI 02840
  • Reassigned Medicare billing, Rhode Island enrollment
  • 72 clinicians in this Medicare group
NPI 1063632180 (401) 444-6905

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 02903 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
$134.17 typical visit price
range $58.57 – $177.03
Typical copayment $33.54 (range $14.64 – $44.25)
Most-billed visit code 99204
Established Patient
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
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.

DR. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695
FANNY HUANG MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4741

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 Isa Jacoba's NPI number?

The NPI number for Isa Jacoba is 1720668064. It was assigned to this individual provider in the NPPES registry on April 12, 2021.

Where is Isa Jacoba located?

Isa Jacoba practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 444-5057.

What is Isa Jacoba's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Isa Jacoba enrolled in Medicare?

Yes. Isa Jacoba is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Isa Jacoba's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Isa Jacoba reassigns Medicare benefits to 6 organizations: Lifespan Physician Group, Inc. (Providence, RI), Rhode Island Hospital (Providence, RI), University Pathologists, LLC (Providence, RI), The Miriam Hospital (Providence, RI), Lifespan Physician Group Of Massachusetts Inc (Taunton, MA) and 1 more organization, listed in the Medicare section above. 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 Isa Jacoba'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 Isa Jacoba was last updated on June 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.