Active NPI
Kenneth H Jacobson, MD
- Pediatric Anesthesiology Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Anesthesiology Physician
- License
- L2345
- Practice address
- 550 1St Ave
New York, NY 10016-6402 - Phone
- (212) 263-5072
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | L2345 | TX | |
| Pediatric Anesthesiology Physician | 207LP3000X | L2345 | TX | Primary |
Addresses
Primary practice location
550 1St Ave
New York, NY 10016-6402
Mailing address
PO Box 99371
Fort Worth, TX 76199-0371
Phone (682) 885-1855
Other practice location 1
801 7th Ave
Fort Worth, TX 76104-2733
Phone (682) 885-4054
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 124217 | Other | TX | SUPERIOR PIN |
| 1447220850 | Other | GRP NPI NUMBER | |
| 1950571 | Other | TX | UHC PIN |
| 10030778 | Other | TX | AMERIGROUP PIN |
| 7067290 | Other | TX | AETNA PIN |
| 0324290 | Other | TX | CIGNA PIN |
| 147834901 | Medicaid | TX | |
| 1192925 | Other | TX | FIRSTHEALTH PIN |
| 140442853 | Medicaid | TX | |
| 00N47F | Other | TX | BCBSTX GRP PIN |
| 147834902 | Medicaid | TX | |
| 115891100 | Other | TX | FIRSTCARE PIN |
| 137345809 | Medicaid | TX | |
| 88413Y | Other | TX | BCBSTX IND PIN |
| 9187586 | Other | TX | PHCS PIN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kjacobson90155@nyumc.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080417000255 | NY | Practitioner - Anesthesiology | 9830277730 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Icahn School of Medicine at Mount Sinai, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- New York University
Practice addresses (Care Compare)
530 1St Ave
New York, NY 10016-6402
550 1St Ave
New York, NY 10016-6402
Phone (212) 263-6037
Hospital & facility affiliations
- NYU Langone Hospitals
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.8 of 100
- Quality
- 91.79
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.18
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L2345 | TX | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Anesthesiology | Current | Accepting new patients |
| New York University | Anesthesiology | Current | Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
550 1st Ave
New York, NY 10016
Phone (212) 263-3293
530 1st Ave
New York, NY 10016
Phone (212) 263-7216
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661731200000",
"number": "1003909193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 99371",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761990371",
"telephone_number": "682-885-1855",
"fax_number": "682-885-7347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100166402",
"telephone_number": "212-263-5072"
}
],
"practiceLocations": [
{
"address_1": "801 7th Ave",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761042733",
"country_code": "US",
"telephone_number": "682-885-4054",
"fax_number": "682-885-7497",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBSON",
"first_name": "KENNETH",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2022-08-29",
"certification_date": "2022-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "L2345",
"primary": false
},
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "TX",
"license": "L2345",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPERIOR PIN",
"identifier": "124217",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GRP NPI NUMBER",
"identifier": "1447220850",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC PIN",
"identifier": "1950571",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP PIN",
"identifier": "10030778",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PIN",
"identifier": "7067290",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PIN",
"identifier": "0324290",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "147834901",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRSTHEALTH PIN",
"identifier": "1192925",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140442853",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSTX GRP PIN",
"identifier": "00N47F",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "147834902",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRSTCARE PIN",
"identifier": "115891100",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "137345809",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSTX IND PIN",
"identifier": "88413Y",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS PIN",
"identifier": "9187586",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kjacobson90155@nyumc.direct-ci.com",
"affiliation": "N",
"address_1": "550 1st Ave",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100166402",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.