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JACOB DALE CAMPBELL D.O.
NPI 1811301377
Surgery - Pediatric Surgery in Farmington, CT

Active since June 12, 2014PECOS EnrolledAccepts Medicare Assignment
UCONN SCHOOL OF MEDICINE DEPT OF SURGERY, 263 FARMINGTON AVE, FARMINGTON, CT 06030(860) 679-2147(860) 679-4624 Get Directions Write a Review

NPPES record last updated: November 20, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 20, 2023, Aug 27, 2023 (2 updates tracked since 2023).

About Jacob Dale Campbell D.o. NPPES

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

JACOB DALE CAMPBELL D.O. (NPI 1811301377) is an individual pediatric surgery provider in Farmington, Connecticut, licensed in Connecticut (75461) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS, maintains a secondary practice location in Hartford, and is a graduate of Nova Southeastern College Of Osteo Medicine (2014).

NPPES Registry Identity

NPI1811301377
Entity TypeIndividualMale
Primary Taxonomy2086S0120X
Provider Legal NameJACOB DALE CAMPBELLCredential: D.O.
Location AddressUCONN SCHOOL OF MEDICINE DEPT OF SURGERY, 263 FARMINGTON AVEFarmington, CT 06030-3955
Mailing AddressUconn School Of Medicine Dept Of Surgery, 263 Farmington AveFarmington, CT 06030-3955 · (860) 679-2147 · Fax (860) 679-4624
Phone(860) 679-2147
Fax(860) 679-4624
Sole ProprietorNo
Medical School CMSNova Southeastern College Of Osteo MedicineGraduated 2014
Enumeration DateJune 12, 2014
Last NPPES UpdateNovember 20, 20232 updates tracked since enumeration
NPPES CertifiedNovember 20, 2023
✔ NPI 1811301377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
License✔ Licensed in CT · 75461
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
UCONN SCHOOL OF MEDICINE DEPT OF SURGERY, Farmington, CT 06030
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Secondary Practice Location 1

Location 1282 Washington St Fl 1Hartford, CT 06106-3322 · Phone (860) 545-9520

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacob Dale Campbell D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527361435
PECOS Enrollment IDI20230831002400
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.

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 Jacob Campbell's NPI number?

The NPI number for Jacob Campbell is 1811301377. It was assigned to this individual provider in the NPPES registry on June 12, 2014.

Where is Jacob Campbell located?

Jacob Campbell practices at Uconn School Of Medicine Dept Of Surgery 263 Farmington Ave, Farmington, CT 06030. The listed phone number is (860) 679-2147.

What is Jacob Campbell's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Is Jacob Campbell enrolled in Medicare?

Yes. Jacob Campbell is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jacob Campbell was last updated on November 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.