Jaisy Jacob, - Medicare Diagnostic Radiology in Detroit, MI

Jaisy Jacob, is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Detroit, Michigan. She graduated from medical school in 2011 and has 13 years of diverse experience with area of expertise as Diagnostic Radiology. She is a member of the group practice Henry Ford Medical Group and her current practice location is 4100 John R St, Detroit, Michigan. You can reach out to her office (for appointments etc.) via phone at (313) 576-9900.

Jaisy Jacob is licensed to practice in Michigan (license number 4301107800) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1639468614.

Contact Information

Jaisy Jacob,
4100 John R St,
Detroit, MI 48201-2013
(313) 576-9900
Not Available



Physician's Profile

Full NameJaisy Jacob
GenderFemale
SpecialityDiagnostic Radiology
Experience13 Years
Location4100 John R St, Detroit, Michigan
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jaisy Jacob graduated from medical school in 2011
  NPI Data:
  • NPI Number: 1639468614
  • Provider Enumeration Date: 03/30/2011
  • Last Update Date: 05/13/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 2466765276
  • Enrollment ID: I20180822001806

Medical Identifiers

Medical identifiers for Jaisy Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1639468614NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085B0100XRadiology - Body Imaging 4301107800 (Michigan)Secondary
2085R0202XRadiology - Diagnostic Radiology 4301107800 (Michigan)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Henry Ford HospitalDetroit, MIHospital
Henry Ford West Bloomfield HospitalWest bloomfield, MIHospital
Henry Ford Macomb HospitalClinton township, MIHospital
Henry Ford Wyandotte HospitalWyandotte, MIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Henry Ford Medical Group05471783112095

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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. Jaisy Jacob allows following entities to bill medicare on her behalf.
Entity NameHenry Ford Health System
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134144801
PECOS PAC ID: 0547178311
Enrollment ID: O20031105000139

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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. Jaisy 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 AddressPractice Location Address
Jaisy Jacob,
4100 John R St,
Detroit, MI 48201-2013

Ph: (313) 576-9900
Jaisy Jacob,
4100 John R St,
Detroit, MI 48201-2013

Ph: (313) 576-9900

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IGC scientist receives a total grant of 1.6 million euro to conduct research on neurological mechanisms

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Radiology Doctors in Detroit, MI

Dr. Brent David Griffith, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 2799 W Grand Blvd, Detroit, MI 48202
Phone: 313-916-2600    
Kanika Khanna, M.D
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 2799 W Grand Blvd, Detroit, MI 48202
Phone: 313-916-2600    
Dr. Michael Matthew Dominello, DO
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 4100 John R, Detroit, MI 48201
Phone: 800-527-6266    Fax: 313-576-9640
Rajinder P. Sharma, M.D.
Radiology
Medicare: Not Enrolled in Medicare
Practice Location: Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202
Phone: 313-916-2436    
Milan V. Pantelic, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202
Phone: 313-916-2436    
Kristan Gail Jenkins-mosure, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 2799 W Grand Blvd, Detroit, MI 48202
Phone: 800-653-6568    
Kristin Booth, DO
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 2799 W Grand Blvd, Detroit, MI 48202
Phone: 517-402-1383    

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