Stacy Jacob
NPI 1104333178 · Physician Assistant · Staten Island, NY
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Stacy Jacob is a Physician Assistant provider in Staten Island, NY (NPI 1104333178).
Provider details
- NPI number
- 1104333178
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 329541-1 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Nursing Service Providers
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2017-12-29
- Last updated
- 2026-02-02
- Certified
- 2026-02-02
Frequently asked questions
- What is Stacy Jacob's NPI number?
- Stacy Jacob's National Provider Identifier (NPI) is 1104333178, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Stacy Jacob's specialty?
- Stacy Jacob is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Stacy Jacob located?
- Stacy Jacob's practice location on file with NPPES is 475 Seaview Ave, Staten Island, NY 10305-3436.
- What is Stacy Jacob's phone number?
- The practice phone number listed in the NPPES registry for Stacy Jacob is (718) 266-9000.
- Does Stacy Jacob accept Medicare?
- Stacy Jacob is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Stacy Jacob's NPI active?
- Yes — Stacy Jacob's NPI (1104333178) is active in the NPPES registry as of the last update on 2026-02-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.