Dr Jack Jacob, DO in Bridgeport, CT

Dr Jack Jacob, DO is a medicare enrolled "Pathology - Anatomic Pathology & Clinical Pathology" physician in Bridgeport, Connecticut. He went to New York College Of Osteo Medicine Of New York Institute Of Technology and graduated in 2015 and has 9 years of diverse experience with area of expertise as Pathology. He is a member of the group practice Fairfield County Pathology Consultants, Llc and his current practice location is 2800 Main St, Bridgeport, Connecticut. You can reach out to his office (for appointments etc.) via phone at (862) 812-7831.

Dr Jack Jacob is licensed to practice in Connecticut (license number 68885) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1649659590.

Contact Information

	Dr Jack Jacob, DO
	2800 Main St, Bridgeport, CT 06606-4201
	(862) 812-7831
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Jack Jacob
Gender	Male
Speciality	Pathology
Experience	9 Years
Location	2800 Main St, Bridgeport, Connecticut
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Jack Jacob attended and graduated from New York College Of Osteo Medicine Of New York Institute Of Technology in 2015

NPI Data:

NPI Number: 1649659590
Provider Enumeration Date: 05/26/2015
Last Update Date: 09/22/2021

Medicare PECOS Information:

PECOS PAC ID: 6608115530
Enrollment ID: I20210810003991

Medical Identifiers

Medical identifiers for Dr Jack Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1649659590	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207ZP0102X	Pathology - Anatomic Pathology & Clinical Pathology	68885 (Connecticut)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
St. Vincent's Medical Center	Bridgeport, CT	Hospital
Hartford Hospital	Hartford, CT	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Fairfield County Pathology Consultants, Llc	7113969833	4

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jack Jacob allows following entities to bill medicare on his behalf.

Entity Name	Gastroenterology Associates Of Fairfield Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285710442 PECOS PAC ID: 3274506290 Enrollment ID: O20040818000151

Entity Name	Fairfield County Pathology Consultants, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518064757 PECOS PAC ID: 7113969833 Enrollment ID: O20050524000533

Entity Name	Connecticut Gi Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023124625 PECOS PAC ID: 9830110758 Enrollment ID: O20070112000011

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack Jacob is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Jack Jacob, DO 2800 Main St, Bridgeport, CT 06606-4201 Ph: (862) 812-7831	Dr Jack Jacob, DO 2800 Main St, Bridgeport, CT 06606-4201 Ph: (862) 812-7831

Reviews and Comments

Pathology Doctors in Bridgeport, CT

Dr. Christine Marianne Minerowicz, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 267 Grant St, Bridgeport, CT 06610 Phone: 203-384-3156 Fax: 203-384-3237
Young Choi Kim, MD Pathology Medicare: Medicare Enrolled Practice Location: 267 Grant St, Bridgeport, CT 06610 Phone: 203-384-3157 Fax: 203-384-3237
Dr. George Michael Golenwsky, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 2800 Main St, Bridgeport, CT 06606 Phone: 203-576-5033
Dr. Saurabh Malhotra, MD Pathology Medicare: Medicare Enrolled Practice Location: 2800 Main St Dept Of, Bridgeport, CT 06606 Phone: 203-576-5033
Dr. Angelique W Levi, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 2800 Main St, St. Vincent's Medical Center, Dept. Of Pathology, Bridgeport, CT 06606 Phone: 203-576-5033
Sumi Varghese Thomas, M.B.B.S Pathology Medicare: Accepting Medicare Assignments Practice Location: 267 Grant St, Bridgeport, CT 06610 Phone: 732-235-8120
Agedi Nicholson Boto, M.D./PH.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 2800 Main St, Bridgeport, CT 06606 Phone: 475-210-5032 Fax: 475-210-5034

Dr Jack Jacob, DO - Medicare Pathology in Bridgeport, CT