Doctor profile · Federal record
Dr. Jaisy Jacob
Diagnostic Radiology Physician (CMS: Diagnostic Radiology) · Body Imaging Physician · Detroit, MI
- NPI 1639468614
- Accepts Medicare
- 15 yrs in practice
- Female
- Group practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
4100 John R St
Detroit, MI 482012013
(313) 576-9900 - Additional location
-
3601 W 13 Mile RD
Royal Oak, MI 48073
(248) 898-6031
Credentials & registration
- NPI registered
- March 2011 — 15 yrs on file
- Profile last updated
- May 13, 2022
- Year of graduation
- 2011 — 15 yrs since
- Specialty taxonomy
- 2085R0202X — NUCC code
- State license (1)
- Michigan #4301107800
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1639468614. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
1,423
Distinct HCPCS
10
Medicare allowed
$50,449
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
77067 |
Screening mammography | 285 | 285 | $37 | |
77067 |
Screening mammography | 270 | 270 | $37 | |
77063 |
Screening 3d breast mammography | 227 | 227 | $29 | |
77063 |
Screening 3d breast mammography | 191 | 191 | $29 | |
G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 111 | 107 | $29 | |
77065 |
Diagnostic mammography of 1 breast | 108 | 99 | $38 | |
76642 |
Limited ultrasound scan of 1 breast | 77 | 76 | $34 | |
77066 |
Diagnostic mammography of both breasts | 43 | 43 | $48 | |
G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 34 | 34 | $30 | |
76642 |
Limited ultrasound scan of 1 breast | 23 | 23 | $36 |
In context: peer comparison
Among 54 peers in Detroit Diagnostic Radiology Physician, average services per provider: 73. This provider delivers 19× the peer median.Hospital affiliations
Frequently asked questions
What is Dr. Jaisy Jacob's medical specialty?
Dr. Jaisy Jacob practices Diagnostic Radiology Physician in Detroit, MI.
Where does Dr. Jaisy Jacob practice?
Dr. Jaisy Jacob practices at 4100 John R St, Detroit, MI 482012013. Office phone: 3135769900.
What is Dr. Jaisy Jacob's NPI?
Dr. Jaisy Jacob's National Provider Identifier (NPI) is 1639468614, issued by NPPES.
Does Dr. Jaisy Jacob accept Medicare assignment?
Yes. Dr. Jaisy Jacob accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Jaisy Jacob commonly perform?
Top Medicare-reported procedures in 2023: Screening mammography (HCPCS 77067); Screening mammography (HCPCS 77067); Screening 3d breast mammography (HCPCS 77063). Source: CMS Medicare Physician & Other Practitioners file.