CHRISTOPHER THOMAS JACOB (STUDENT) – Certified Registered Nurse Anesthetist, NPI 1396388674

CHRISTOPHER THOMAS JACOB (STUDENT) is a healthcare provider. based in Melbourne, Florida. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials STUDENT. They hold a License No. APRN11006614 (FL). The NPI Number for CHRISTOPHER THOMAS JACOB (STUDENT) is 1396388674

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
CHRISTOPHER THOMAS JACOB (STUDENT)
NPI
1396388674
Phone
(407) 375-7856
Address
812 HANDSOME CAB LN APT 104
Enumeration Date
19 October 2019
Last Update Date
21 April 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3522533333
Graduation Year
2020 (6 years ago)
PAC ID
6406286988
Group Practice PAC ID
0345143152
Professional Enrollment ID
I20200424000026
Address ID
FL327785266TA1000XWAYX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

5,360 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in FL

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Provider Addresses for CHRISTOPHER THOMAS JACOB (STUDENT)

  • 812 HANDSOME CAB LN APT 104

    MELBOURNE, FL 329408252

    Phone: (407) 375-7856

    Type: Mailing

  • Florida Hospital Waterman, 1000, Waterman Way, Tavares, Lake County, Florida, 34778, United States

    TAVARES, FL 327785266

    Phone: (352) 253-3333

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $55.

Total Amount is formed as General ($55) + Research ($0) + Ownership ($0) = $55.

Last reported payment date: 2024-08-28 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($55).

Total Amount

$55

General + Research + Ownership

Payments

2

Total payment records

General Amount

$55

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-28

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Merck Sharp & Dohme LLC$55
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: 2020-04-24

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
I20200424000026ICertified Registered Nurse Anesthetist (Crna)FLTBD

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
01402Anesthesia for procedure for total knee joint replacement2423$0
00670Anesthesia for extensive surgery on spine1717$0
00790Anesthesia for other procedure on upper abdomen1515$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1414$0
01210Anesthesia for other procedure on hip joint1111$0
View full utilization report →

Insurance plans in this area (ZIP 32940)

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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: 0345143152View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YFL
Certified Registered Nurse Anesthetist (Crna)FL
-FL
A N E S T H E S I O L O G YFL
Certified Registered Nurse Anesthetist (Crna)FL
A N E S T H E S I O L O G YFL
A N E S T H E S I O L O G YFL
-FL
-FL
A N E S T H E S I O L O G YFL

Reviews

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Frequently asked questions

What number should I use to identify CHRISTOPHER THOMAS JACOB (STUDENT) for billing?
Administrative and clinical systems typically use NPI 1396388674 for CHRISTOPHER THOMAS JACOB (STUDENT).
Is CHRISTOPHER THOMAS JACOB (STUDENT) currently accepting referrals based on NPI status?
Registry metadata lists CHRISTOPHER THOMAS JACOB (STUDENT) as active.
How should patients interpret CHRISTOPHER THOMAS JACOB (STUDENT)'s specialty?
The extract shows Certified Registered Nurse Anesthetist for CHRISTOPHER THOMAS JACOB (STUDENT). Clinical services aligned with this taxonomy classification.
What geographic area is tied to CHRISTOPHER THOMAS JACOB (STUDENT)?
CHRISTOPHER THOMAS JACOB (STUDENT) is associated with Melbourne, Florida in the same public data insurers reference.
Why is information missing for CHRISTOPHER THOMAS JACOB (STUDENT)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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