NPIMap

Individual provider Active NPI

Matthew W Jacobsen, MD

  • Family Medicine Physician
  • Lincoln, NE
National Provider Identifier
1003913138
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23135 Issued in NE
Practice address
4600 Valley Rd Ste 200
Lincoln, NE 68510-4882
Phone
(402) 483-4571
Fax
(402) 483-5633
NPI assigned
Sep 20, 2006
Last updated
Oct 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23135 NE Primary

Addresses

Primary practice location

4600 Valley Rd Ste 200
Lincoln, NE 68510-4882

Mailing address

4600 Valley Rd Ste 200
Lincoln, NE 68510-4882
Phone (402) 483-4571

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050720000767 NE Practitioner - Family Practice 8527968205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lincoln Medical Education PartnershipGroup PAC ID 4880645407, 16 clinicians

Practice addresses (Care Compare)

4600 Valley Rd
Suite 200
Lincoln, NE 68510-4882
Phone (402) 483-4571

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rheumatology & Osteoporosis Services, P.C. CurrentSince Sep 12, 2022 Accepting new patients
Lincoln Medical Education Partnership Family Medicine CurrentSince Feb 29, 2024 Accepting new patients
Nemri Medical Services, Inc. Family Medicine Past Accepting new patients
Saint Elizabeth Regional Medical Center Past Accepting new patients
Bryan Medical Center Past Accepting new patients

Locations

4600 Valley Rd
Ste 200
Lincoln, NE 68510
Phone (402) 483-4571

7441 O St
Ste 400
Lincoln, NE 68510
Phone (402) 464-9000

Interoperability endpoints

  • FHIR API: https://fhir.madonna.org/R4/open-Prod
  • Direct secure messaging: matthew.jacobsen.1@9271.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1003913138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 VALLEY RD STE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104882",
            "telephone_number": "402-483-4571",
            "fax_number": "402-483-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 VALLEY RD STE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104882",
            "telephone_number": "402-483-4571",
            "fax_number": "402-483-5633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "MATTHEW",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "23135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.