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

Renatta Jacobs

Individual provider Primary Care Nurse Practitioner · NPI 1235725326

Renatta Jacobs is a Nurse Practitioner in Lodi, New Jersey. Qualified in 2020, 6 years ago. Practices with Icahn School of Medicine at Mount Sinai, a 2,791-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2020

Practice location Address checks out

114 Spring St
Lodi, NJ 07644-3125
Phone: (347) 837-6360
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence F309729 (NY)

Record details

NPI number1235725326
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 14, 2020
Last updated in NPPESDecember 14, 2020
Certification dateDecember 9, 2020
Mailing address114 Spring St, Lodi, NJ 07644-3125

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Icahn School Of Medicine At Mount Sinai — 2791 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare