Individual provider Active NPI

James H Jacobs Jr., MD

  • Diagnostic Radiology Physician
  • Clive, IA
National Provider Identifier
1003895962
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
33546 Issued in MN
Practice address
12368 Stratford Dr
Suite 300
Clive, IA 50325-8162
Phone
(515) 226-9810
Fax
(515) 961-2714
NPI assigned
Jan 10, 2006
Last updated
Jun 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 33546 MN Primary

Addresses

Primary practice location

12368 Stratford Dr
Suite 300
Clive, IA 50325-8162

Mailing address

12368 Stratford Dr
Suite 300
Clive, IA 50325-8162
Phone (515) 226-9810

Other identifiers 1

IdentifierTypeStateIssuer
668214600MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050207000727 MN Practitioner - Diagnostic Radiology 2860481355 Reassigns benefits to 2 organizations
I20051117000763 IA Practitioner - Diagnostic Radiology 2860481355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.64 of 100Reported as group
Quality
78.11
Improvement activities
40
Cost
78.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6098NDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
BTX Iowa Inc CurrentSince Sep 1, 2015 Accepting new patients
Maplewood Imaging Center LLC Diagnostic Radiology PastSince Jan 1, 2008 Accepting new patients
West Central Radiological Associates, LTD Diagnostic Radiology Past Accepting new patients
Midwest Radiology Outpatient Imaging, LLC Diagnostic Radiology Past Accepting new patients
Midwest Radiology, PA Diagnostic Radiology Past Accepting new patients

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1003895962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12368 STRATFORD DR",
            "address_2": "SUITE 300",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258162",
            "telephone_number": "515-226-9810",
            "fax_number": "515-961-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12368 STRATFORD DR",
            "address_2": "SUITE 300",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258162",
            "telephone_number": "515-226-9810",
            "fax_number": "515-961-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JAMES",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "33546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "668214600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.