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

Jennie Z Jacob, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1255695003

Jennie Z Jacob, PHYSICIANASSISTANT is a Physician Assistant in Setauket, New York. Qualified in 2012, 14 years ago. Practices with Stony Brook Urology University Faculty Practice Corporation, a 37-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
14
Licensed in
NY
In the registry since
2012
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Practice location Address checks out

24 Research Way
Setauket, NY 11733-3487
Phone: (631) 444-6270
Fax: (631) 444-7620
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 015645 (NY)

Record details

NPI number1255695003
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedJune 26, 2012
Last updated in NPPESMarch 18, 2016

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Stony Brook Urology University Faculty Practice Corporation — 37 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Setauket