JEENA JACOB (APRN) – Adult Health Nurse Practitioner, NPI 1316522253

JEENA JACOB (APRN) is a healthcare provider. based in Los angeles, California. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 95016908 (CA). The NPI Number for JEENA JACOB (APRN) is 1316522253

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
JEENA JACOB (APRN)
NPI
1316522253
Phone
(310) 913-4168
Address
4314 GRAND VIEW BLVD
Enumeration Date
12 March 2021
Last Update Date
31 October 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3104504772
Graduation Year
2020 (6 years ago)
PAC ID
0446773709
Group Practice PAC ID
5698667749
Professional Enrollment ID
I20250327000062
Address ID
CA902304605CU3861XBLVD300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for JEENA JACOB (APRN)

  • 4314 GRAND VIEW BLVD

    LOS ANGELES, CA 900666229

    Phone: (310) 913-4168

    Type: Mailing

  • 985 W VERNON AVE

    LOS ANGELES, CA 900373038

    Phone: (323) 234-6300

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $23.

Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.

Last reported payment date: 2023-07-20 • Largest payer in this snapshot: Ultragenyx Pharmaceutical Inc. ($23).

Total Amount

$23

General + Research + Ownership

Payments

1

Total payment records

General Amount

$23

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-07-20

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250327000062INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90066)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5698667749View full group profile
NameSpecialtyState
Physician AssistantCA
Nurse PractitionerCA
Family PracticeCA
Nurse PractitionerCA
Physician AssistantCA
Internal Medicine, Pediatric MedicineCA
Family PracticeNY
Family PracticeCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

How is JEENA JACOB (APRN) identified in CMS data?
CMS-hosted NPPES data lists JEENA JACOB (APRN) with NPI 1316522253.
Does the file indicate JEENA JACOB (APRN) is practicing under active NPI?
Directory data currently reports JEENA JACOB (APRN) as active.
What is JEENA JACOB (APRN)'s primary classification?
Adult Health Nurse Practitioner is the headline specialty for JEENA JACOB (APRN) here. Clinical services aligned with this taxonomy classification.
Does JEENA JACOB (APRN) list a practice location?
Patients near Los Angeles, California may find JEENA JACOB (APRN) in results; validate coverage separately.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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