Dr Mridula A Jacob, MD is a medicare enrolled "Allergy & Immunology" physician in New Hartford, New York. She graduated from medical school in 2015 and has 9 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Baystate Medical Practices Inc and her current practice location is
1729 Burrstone Rd, New Hartford, New York. You can reach out to her office (for appointments etc.) via phone at
(315) 798-1434.
Dr Mridula A Jacob is licensed to practice in New York (license number 295165) 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 1023491701.
Physician's Profile
| Full Name | Dr Mridula A Jacob |
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| Gender | Female |
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| Speciality | Internal Medicine |
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| Experience | 9 Years |
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| Location | 1729 Burrstone Rd, New Hartford, New York |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Mridula A Jacob graduated from medical school in 2015
NPI Data:
- NPI Number: 1023491701
- Provider Enumeration Date: 06/30/2015
- Last Update Date: 07/11/2024
Medicare PECOS Information:
- PECOS PAC ID: 6507116324
- Enrollment ID: I20190122003099
Medical Identifiers
Medical identifiers for Dr Mridula A Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1023491701 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207K00000X | Allergy & Immunology | 295165 (New York) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Baystate Medical Practices Inc | 5991602971 | 1008 |
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. Dr Mridula A Jacob allows following entities to bill medicare on her behalf.
| Entity Name | Baystate Medical Practices Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1548205909
PECOS PAC ID: 5991602971
Enrollment ID: O20040225000080 |
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| Entity Name | Berkshire Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1295765261
PECOS PAC ID: 1355232711
Enrollment ID: O20040324000088 |
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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. Dr Mridula A 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 Address | Practice Location Address |
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Dr Mridula A Jacob, MD
1729 Burrstone Rd,
New Hartford, NY 13413-1001
Ph: (315) 798-1434 | Dr Mridula A Jacob, MD
1729 Burrstone Rd,
New Hartford, NY 13413-1001
Ph: (315) 798-1434 |
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