Individual provider Active NPI

Elizabeth A Jacobs, MD

  • Internal Medicine Physician
  • Riverside, CA
National Provider Identifier
1023046059
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C199381 Issued in CA
Practice address
3390 University Ave Ste 100
Riverside, CA 92501-3315
Phone
(844) 827-8000
NPI assigned
Jun 29, 2006
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 55569-20 WI
Internal Medicine Physician 207R00000X R8916 TX
Internal Medicine Physician 207R00000X MD24137 ME
Internal Medicine Physician 207R00000X C199381 CA Primary

Addresses

Primary practice location

3390 University Ave Ste 100
Riverside, CA 92501-3315

Mailing address

3390 University Ave Ste 100
Riverside, CA 92501-3315
Phone (844) 827-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20241016002668 CA Practitioner - Internal Medicine 3779586581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, San Francisco School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3390 University Ave
Suite 100
Riverside, CA 92501-3315
Phone (951) 827-7793

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C199381CAMDInternal Medicine Physician
R8916TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ucr Health - Psychiatry CurrentSince Nov 1, 2024 Accepting new patients
Regents of the University of California CurrentSince Nov 1, 2024 Accepting new patients
University Surgeons of Orange a Medical Group Past Accepting new patients

Locations

3390 University Ave
Riverside, CA 92501
Phone (951) 447-4697

3390 University Ave
Ste 1
Riverside, CA 92501
Phone (951) 827-7793

3390 University Ave
Ste 100
Riverside, CA 92501
Phone (844) 827-8000

3390 University Ave
Ste 115
Riverside, CA 92501
Phone (844) 827-8000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, 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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1023046059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 UNIVERSITY AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013315",
            "telephone_number": "844-827-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 UNIVERSITY AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013315",
            "telephone_number": "844-827-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "55569-20",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R8916",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD24137",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C199381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.