Tracy Michelle Jacobs

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.021732 Issued in IL

Practice address

1658 S Il Route 2
Oregon, IL 61061-9514

Phone

(815) 732-2499

Fax

(815) 732-6077

NPI assigned

Dec 2, 2019

Last updated

Dec 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Deer Oaks Mid-West LLCGroup PAC ID 2264762681, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.66 of 100Reported as group

Quality

80.64

Improvement activities

40

Cost

74.35

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Deer Oaks Mid-West LLC

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1154978476

  IL

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1023655750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 N 5TH ST",
            "city": "OREGON",
            "state": "IL",
            "postal_code": "610611203",
            "telephone_number": "815-262-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1658 S IL ROUTE 2",
            "city": "OREGON",
            "state": "IL",
            "postal_code": "610619514",
            "telephone_number": "815-732-2499",
            "fax_number": "815-732-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "TRACY",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawood Fakirmohamed Harunani, DDS
• Alexis Hecker
• Anne Hermes, MHP
• Seretha Hollingsworth
• Jamie Lynn Houseman, LCSW
• Christina B Jensen, D.C.
• Spring Johansson
• Joseph Kerwin DDS PC
• Juliette A Kalweit Schmeling, M.D.
• Ashleigh Lamb

• Clinical Social Worker in Oregon, IL
• Providers in Oregon, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.