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: July 19, 2026.

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

  • Individual
  • Male
  • Years of Experience 13
  • Surgery
  • Pediatric Surgery
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JACOB CAMPBELL

This page provides the complete NPI Profile along with additional information for Jacob Campbell, a provider established in Farmington, Connecticut with a medical specialization in Surgery, focusing in pediatric surgery and more than 13 years of experience. He graduated from Nova Southeastern College Of Osteo Medicine in 2014. The healthcare provider is registered in the NPI registry with number 1811301377 assigned on June 2014. The practitioner's primary taxonomy code is 2086S0120X with license number 75461 (CT). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1811301377 Verify this NPI
Provider Name
JACOB DALE CAMPBELL D.O.
Gender
Male
Entity Type
Individual
Location Address
UCONN SCHOOL OF MEDICINE DEPT OF SURGERY 263 FARMINGTON AVE FARMINGTON, CT 06030
Location Phone
(860) 679-2147
Location Fax
(860) 679-4624
Mailing Address
UCONN SCHOOL OF MEDICINE DEPT OF SURGERY 263 FARMINGTON AVE FARMINGTON, CT 06030
Mailing Phone
(860) 679-2147
Mailing Fax
(860) 679-4624
Medical School Name
NOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Graduation Year
2014
Is Sole Proprietor?
No
Enumeration Date
06-12-2014
Last Update Date
11-20-2023
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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

Surgery Pediatric Surgery

Taxonomy Code
2086S0120X
Type
Allopathic & Osteopathic Physicians
License No.
75461
License State
CT
Taxonomy Description
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

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)
1390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Medicare Participation & PECOS Enrollment Status

Jacob Campbell 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.

Jacob Campbell 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: 8527361435

    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: I20230831002400

    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

Reviews for JACOB DALE CAMPBELL D.O.

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1811301377, enumerated as an "individual" on June 12, 2014.

The provider is located at UCONN SCHOOL OF MEDICINE DEPT OF SURGERY 263 FARMINGTON AVE FARMINGTON, CT 06030 and the phone number is (860) 679-2147.

Surgery with taxonomy code 2086S0120X and a focus in Pediatric Surgery.