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

Samuel Sunny Jacob, DO

Individual provider Sports Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1134651391

Samuel Sunny Jacob, DO is a Physical Medicine and Rehabilitation in Ridgewood, New Jersey. Graduated from National College of Chiropractic in 2017, 9 years ago. Practices with Valley Physician Services PC, a 592-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
9
Trained at
National College of Chiropractic
Licensed in
NJ
In the registry since
2017
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.

See every abbreviation used in this directory →

Practice location Address checks out

1200 E Ridgewood Avenue East Wing Ste 306
Ridgewood, NJ 07450
Phone: (201) 612-4857
Show map & directions

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

Specialties & licences

Sports Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081S0010X · Licence 25MB11490200 (NJ)

Record details

NPI number1134651391
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 28, 2017
Last updated in NPPESAugust 18, 2022
Certification dateAugust 18, 2022
Mailing address18 Martino Way, Pomona, NY 10970-2649

Medicare enrollment

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

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolNATIONAL COLLEGE OF CHIROPRACTIC
Graduated 2017 (9 years in practice)
Group practice Valley Physician Services Pc — 592 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare