Jacob Matthew Ernst, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

02005164A Issued in IN

Practice address

9040 Jackson Ave
Joint Base Lewis McChord, WA 98431-1000

Phone

(253) 968-0369

NPI assigned

Mar 3, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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 1

Specialty

Emergency Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Emergency Professionals of Indiana PCGroup PAC ID 4183604150, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100
• Ascension St Vincent Warrick Hospital, Boonville, IN, CCN 151325

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Cep America LLC

  • Emergency Medicine Physician
  • Terre Haute, IN
  • NPI 1285103671
  Medicare reassignment Care Compare group NPD
• Emergency Professionals of Indiana, P.C.

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1013951219
  Medicare reassignment Care Compare group NPD
• Concord Company of Tennessee PLLC

  • Emergency Medicine Physician
  • Leitchfield, KY
  • NPI 1649743667

  IN

  Medicare reassignment NPD
• Baptist Health Medical Group Inc

  • Urgent Care Clinic/Center
  • Louisville, KY
  • NPI 1508269200

  IN

  Medicare reassignment
• Cep America LLC

  • Emergency Medicine Physician
  • Indianapolis, IN
  • NPI 1548912553
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Mary'S Health, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1427082957
  Care Compare affiliation
• St. Mary'S Warrick Hospital, Inc.

  • Critical Access Hospital
  • Boonville, IN
  • NPI 1205828803
  Care Compare affiliation

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1013377084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984311000",
            "telephone_number": "253-968-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNST",
        "first_name": "JACOB",
        "middle_name": "MATTHEW",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-03",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02005164A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brody Jules Elliott
• Crystal Berniece Ellis
• Trent Parker Ellis, DMD
• Arie Emde, DNP, APRN, AGCNS-BC
• Samantha Erdman
• David Conor Evans, MD
• Heather Fairfax, REGISTERED NURSE
• Thor Farnsworth, M.D.
• Kimberly Ann Fay, RN
• Quantrell L Felder, LPN

• Emergency Medicine Physician in Joint Base Lewis McChord, WA
• Providers in Joint Base Lewis McChord, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.

Verify at the official NPI Registry.