Samuel Sunny Jacob, DO - Medicare Physical Medicine & Rehabilitation in Ridgewood, NJ

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Samuel Sunny Jacob, DO is a medicare enrolled "Physical Medicine & Rehabilitation - Sports Medicine" physician in Ridgewood, New Jersey. His current practice location is 1200 East Ridgewood Avenue, East Wing, Suite 306,, Ridgewood, New Jersey. You can reach out to his office (for appointments etc.) via phone at (201) 612-4857.

Samuel Sunny Jacob is licensed to practice in New Jersey (license number 25MB11490200) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1134651391.

Contact Information

Samuel Sunny Jacob, DO
1200 East Ridgewood Avenue, East Wing, Suite 306,,
Ridgewood, NJ 07450
(201) 612-4857
Not Available

Map and Direction




Physician's Profile

Full NameSamuel Sunny Jacob
GenderMale
SpecialityPhysical Medicine & Rehabilitation - Sports Medicine
Location1200 East Ridgewood Avenue, Ridgewood, New Jersey
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1134651391
  • Provider Enumeration Date: 03/28/2017
  • Last Update Date: 08/18/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 6507100112
  • Enrollment ID: I20220901001515

Medical Identifiers

Medical identifiers for Samuel Sunny Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1134651391NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2081S0010XPhysical Medicine & Rehabilitation - Sports Medicine 25MB11490200 (New Jersey)Primary

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. Samuel Sunny Jacob allows following entities to bill medicare on his behalf.
Entity NameValley Physician Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467815928
PECOS PAC ID: 3577857333
Enrollment ID: O20160802002824

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. Samuel Sunny 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
Samuel Sunny Jacob, DO
18 Martino Way,
Pomona, NY 10970-2649

Ph: (914) 318-0088		Samuel Sunny Jacob, DO
1200 East Ridgewood Avenue, East Wing, Suite 306,,
Ridgewood, NJ 07450

Ph: (201) 612-4857

Reviews and Comments


Physical Medicine & Rehabilitation Doctors in Ridgewood, NJ

Randy F Marrinan, MD
Physical Medicine & Rehabilitation
Medicare: Not Enrolled in Medicare
Practice Location: 85 S Maple Ave, Ridgewood, NJ 07450
Phone: 201-445-2830    Fax: 201-445-7471
Dr. Rehan Ali, M.D.
Physical Medicine & Rehabilitation
Medicare: Accepting Medicare Assignments
Practice Location: 1144 E Ridgewood Ave Fl 2, Ridgewood, NJ 07450
Phone: 201-336-0188    Fax: 201-336-0141
Samantha Sabban, DO
Physical Medicine & Rehabilitation
Medicare: Medicare Enrolled
Practice Location: 1144 E Ridgewood Ave Fl 2, Ridgewood, NJ 07450
Phone: 201-336-0188    
Dr. Beena S Balakrishnan, M.D.
Physical Medicine & Rehabilitation
Medicare: Medicare Enrolled
Practice Location: 223 N Van Dien Ave, Ridgewood, NJ 07450
Phone: 201-690-6122    
Angela M D'alessandro, MD
Physical Medicine & Rehabilitation
Medicare: May Accept Medicare Assignments
Practice Location: 505 Goffle Rd, Ridgewood, NJ 07450
Phone: 201-251-3304    Fax: 201-447-8526
Dr. Lauren M Terranova, D.O.
Physical Medicine & Rehabilitation
Medicare: Accepting Medicare Assignments
Practice Location: 85 S Maple Ave, Ridgewood, NJ 07450
Phone: 201-445-2830    Fax: 201-445-7471

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.