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AUSTIN JOLY JACOB DMD
NPI 1790495760
Dentist in Riverside, NJ

Active since December 01, 2022PECOS Enrolled
123 S PAVILION AVE, RIVERSIDE, NJ 08075(856) 393-8510 Get Directions Write a Review

NPPES record last updated: February 18, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 18, 2025, Dec 1, 2022 (2 updates tracked since 2022).

About Austin Joly Jacob Dmd NPPES

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

AUSTIN JOLY JACOB DMD (NPI 1790495760) is an individual dentist in Riverside, New Jersey, licensed in Pennsylvania (DS043994) and active in the NPI registry since December 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790495760
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameAUSTIN JOLY JACOBCredential: DMD
Location Address123 S PAVILION AVERiverside, NJ 08075-3611
Mailing Address123 S Pavilion AveRiverside, NJ 08075-3611 · (856) 393-8510
Phone(856) 393-8510
Sole ProprietorYes
Enumeration DateDecember 1, 2022
Last NPPES UpdateFebruary 18, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 18, 2025
✔ NPI 1790495760 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Licenses✔ Licensed in PA · DS043994✔ Licensed in NJ · 22DI02940800
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
123 S PAVILION AVE, Riverside, NJ 08075
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware 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)

Austin Joly Jacob Dmd 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 Austin Jacob reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Quality Community Health Care, Inc.
12 mi
Federally Qualified Health Center (FQHC)
2501 W LEHIGH AVE
Philadelphia, PA 19132
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 18 clinicians in this Medicare group
NPI 1861490583 (215) 227-0300

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 08075 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
$94.90 typical visit price
range $61.59 – $185.05
Typical copayment $23.72 (range $15.39 – $46.26)
Most-billed visit code 99203
Established Patient
$76.45 typical visit price
range $20.08 – $150.98
Typical copayment $19.11 (range $5.02 – $37.74)
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.

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 Austin Jacob's NPI number?

The NPI number for Austin Jacob is 1790495760. It was assigned to this individual provider in the NPPES registry on December 1, 2022.

Where is Austin Jacob located?

Austin Jacob practices at 123 S Pavilion Ave, Riverside, NJ 08075. The listed phone number is (856) 393-8510.

What is Austin Jacob's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Austin Jacob enrolled in Medicare?

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

Which organization bills Medicare for Austin Jacob's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Austin Jacob reassigns Medicare benefits to Quality Community Health Care, Inc. (Philadelphia, PA). 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 Austin Jacob's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Austin Jacob accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, Anthem Blue Cross and Blue Shield and BEST Life and 11 other insurers list Austin 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 Austin Jacob was last updated on February 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.