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DR. MARIANN C. JACOB M.D.
NPI 1811301799
Pediatrics in New York, NY

Active since June 18, 2014PECOS Enrolled
430 EAST 34TH STREET, NEW YORK, NY 10016(866) 733-7698(212) 562-6019 Get Directions Write a Review

NPPES record last updated: March 19, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 9, 2023, Oct 3, 2019, Mar 1, 2016 (3 updates tracked since 2016).

About Dr. Mariann C. Jacob M.d. NPPES

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

DR. MARIANN C. JACOB M.D. (NPI 1811301799) is an individual pediatrics provider in New York, New York, licensed in New York (316056) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1811301799
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. MARIANN C. JACOBCredential: M.D.
Location Address430 EAST 34TH STREETNew York, NY 10016
Mailing Address432 Argyle RdMineola, NY 11501-1014 · (847) 208-3277
Phone(866) 733-7698
Fax(212) 562-6019
Sole ProprietorNo
Enumeration DateJune 18, 2014
Last NPPES UpdateMarch 19, 20243 updates tracked since enumeration
NPPES CertifiedMarch 19, 2024
✔ NPI 1811301799 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in NY · 316056✔ Licensed in WI · 62609-20✔ Licensed in IL · 036.35602
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedHospitalistTaxonomy 208M00000X · License 62609 (WI)
430 EAST 34TH STREET, New York, NY 10016
Open in Google Maps ↗

Secondary Practice Locations 3

Location 13801 Spring StMount Pleasant, WI 53405-1667 · Phone (262) 337-7050 · Fax (262) 337-7860
Location 29000 W Wisconsin AveMilwaukee, WI 53226-4874 · Phone (414) 337-7050 · Fax (414) 337-7020
Location 3801 S Milwaukee AveLibertyville, IL 60048-3204 · Phone (847) 990-5260 · Fax (847) 362-8031

Other Identifiers 2

Medicaid07137497NY
Medicaid1811301799WI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mariann C. Jacob M.d. 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

2

Medicare enrollment records show Mariann Jacob reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Stony Brook Children's Service, University Faculty Practice Corporatio
46 mi
Pediatrics
SUNY @ STONY BROOK, HSC, L11, RM 020
Stony Brook, NY 11794
  • Reassigned Medicare billing, New York enrollment
  • 191 clinicians in this Medicare group
NPI 1083660575 (631) 444-1362
New York University
1,039 mi
Cardiovascular Disease
3301 QUANTUM BLVD
Boynton Beach, FL 33426
  • Reassigned Medicare billing, New York enrollment
  • 7,712 clinicians in this Medicare group
NPI 1285826438 (877) 648-2964

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 10016 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
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
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.

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 Mariann Jacob's NPI number?

The NPI number for Mariann Jacob is 1811301799. It was assigned to this individual provider in the NPPES registry on June 18, 2014.

Where is Mariann Jacob located?

Mariann Jacob practices at 430 East 34th Street, New York, NY 10016. The listed phone number is (866) 733-7698.

What is Mariann Jacob's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mariann Jacob enrolled in Medicare?

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

Which organizations bill Medicare for Mariann Jacob's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mariann Jacob reassigns Medicare benefits to 2 organizations: Stony Brook Children's Service, University Faculty Practice Corporatio (Stony Brook, NY) and New York University (Boynton Beach, FL). 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 Mariann Jacob'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 Mariann Jacob was last updated on March 19, 2024. 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.