DR. JACK JACOB (D.O.) – Anatomic Pathology & Clinical Pathology Physician, NPI 1649659590
Anatomic Pathology & Clinical Pathology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,421 PATHOLOGY in NY
Provider Addresses for DR. JACK JACOB (D.O.)
2800 MAIN ST
BRIDGEPORT, CT 066064201
Phone: (862) 812-7831
Type: Mailing
111 E 210TH ST
BRONX, NY 104672401
Phone: (718) 920-4321
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 $29.
Total Amount is formed as General ($29) + Research ($0) + Ownership ($0) = $29.
Last reported payment date: 2024-04-16 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($29).
Total Amount
$29
General + Research + Ownership
Payments
1
Total payment records
General Amount
$29
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $29 |
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: 2021-08-10
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210810003991 | I | Pathology | CT | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 1,404 | 650 | $0 |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 375 | 156 | $0 |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 338 | 108 | $0 |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 182 | 154 | $0 |
| 88307 | Pathology examination of tissue using a microscope, moderately high complexity | 174 | 95 | $0 |
Insurance plans in this area (ZIP 06606)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| - | CT | |
| P A T H O L O G Y | CT | |
| P A T H O L O G Y | NY |
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