Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Bobby Mathew Jacob, MD

Individual provider Gastroenterology Physician · NPI 1124445275

Dr. Bobby Mathew Jacob, MD is a Gastroenterology in Raleigh, North Carolina. Qualified in 2014, 12 years ago. Practices with North Carolina Mg LLC, a 712-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana and North Carolina.

Years since qualifying
12
Licensed in
IN, NC
In the registry since
2014
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4420 Lake Boone Trl
Raleigh, NC 27607-7505
Phone: (919) 784-5050
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 — (260) 266-5230

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence 2023-00513 (NC)
Gastroenterology Physician Taxonomy 207RG0100X · Licence 01085787A (IN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1124445275
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 26, 2014
Last updated in NPPESJuly 31, 2023
Certification dateJuly 31, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGASTROENTEROLOGY
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice North Carolina Mg Llc — 712 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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