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

Dr. Jack Jacob, DO

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1649659590

Dr. Jack Jacob, DO is a Pathology in Bridgeport, Connecticut. Graduated from New York College of Osteo Medicine of New York Institute of Technology in 2015, 11 years ago. Practices with Fairfield County Pathology Consultants, LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
11
Trained at
New York College of Osteo Medicine of New York Institute of Technology
Licensed in
CT
In the registry since
2015
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2800 Main St
Bridgeport, CT 06606-4201
Phone: (862) 812-7831
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 68885 (CT)

Record details

NPI number1649659590
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedMay 26, 2015
Last updated in NPPESSeptember 22, 2021
Certification dateSeptember 22, 2021
Mailing address2800 Main St, Bridgeport, CT 06606-4201

Medicare enrollment

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

Medicare specialtyPATHOLOGY
Medical schoolNEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduated 2015 (11 years in practice)
Group practice Fairfield County Pathology Consultants, Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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