NAOMI JACOBS (PH.D.) – Clinical Psychologist, NPI 1275641110

NAOMI JACOBS (PH.D.) is a healthcare provider. based in Ponte vedra beach, Florida. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PY6330 (FL). The NPI Number for NAOMI JACOBS (PH.D.) is 1275641110

Main info

Female
Sole Proprietor
29 Years Of Experience
Accepts Medicare Assignment
Name
NAOMI JACOBS (PH.D.)
NPI
1275641110
Phone
(904) 687-6336
Address
100 EXECUTIVE WAY
Enumeration Date
29 August 2006
Last Update Date
30 September 2013

Doctor Profile

Medical School Name
NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Secondary Phone
9046876336
Graduation Year
1997 (29 years ago)
PAC ID
8224298930
Professional Enrollment ID
I20120423000250
Address ID
FL320822715PO100XXWAYX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,602 CLINICAL PSYCHOLOGIST in FL

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Provider Addresses for NAOMI JACOBS (PH.D.)

  • 100, Executive Way, Ponte Vedra Beach, Saint Johns County, Florida, 32082, United States

    SUITE 207

    PONTE VEDRA BEACH, FL 320822715

    Phone: (904) 687-6336

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2012-04-23

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
I20120423000250IClinical PsychologistFLTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour20324$0
90791Psychiatric diagnostic evaluation1313$0
View full utilization report →

Insurance plans in this area (ZIP 32082)

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Reviews

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Frequently asked questions

How do I look up NAOMI JACOBS (PH.D.) by NPI?
Use NPI 1275641110 when you need to reference NAOMI JACOBS (PH.D.) in forms, claims, or directories.
Is NAOMI JACOBS (PH.D.) currently active in the NPI registry?
CMS-published data lists NAOMI JACOBS (PH.D.) as an active registrant.
Does NAOMI JACOBS (PH.D.) list a primary specialty?
If you are matching referrals, note Clinical Psychologist for NAOMI JACOBS (PH.D.). Clinical services aligned with this taxonomy classification.
Where is NAOMI JACOBS (PH.D.)'s primary listing?
We display Ponte Vedra Beach, Florida because that is what the record indicates for NAOMI JACOBS (PH.D.).
Is NAOMI JACOBS (PH.D.) a real provider?
This page reflects official NPPES data for NPI 1275641110. Always confirm identity and privileges with the practice and licensing boards.

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