Laurie Jacobson, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

MD00044247 Issued in WA

Practice address

21600 Highway 99
Ste 280
Edmonds, WA 98026-8012

Phone

(425) 774-2616

NPI assigned

Jul 13, 2006

Last updated

Apr 28, 2008By 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 WA

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

Dermatology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Silver Falls Dermatology LLCGroup PAC ID 5890863492, 100 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• WA PPO C-SNP
• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

• Direct secure messaging: ljacobson@frontierdermpartners.emadirect.md

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.

• Silver Falls Dermatology, LLC

  dba Frontier Dermatology

  • Dermatology Physician
  • Salem, OR
  • NPI 1134375421

  Mohs-Micrographic Surgery, WA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1043235492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 HIGHWAY 99",
            "address_2": "STE 280",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268012",
            "telephone_number": "425-774-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21600 HIGHWAY 99",
            "address_2": "STE 280",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268012",
            "telephone_number": "425-774-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "LAURIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WA",
            "license": "MD00044247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nanette Kaiuelani Jackson
• Gary J Jacky, DMD
• Carole J Jacobson, LMFT
• Ian Jacobson
• Kevin Jacobson
• Virginia Jaggi
• James D. Haberman, Jr. DDS, PLLC
• James Nguyen DMD PS
• Kathi A James, OT
• Colleen Jamieson, ND

• MOHS-Micrographic Surgery Physician in Edmonds, WA
• Providers in Edmonds, WA by specialty
• MOHS-Micrographic Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.