Individual provider Active NPI

Andrew D Jacobs, MD

  • Hematology & Oncology Physician
  • Seattle, WA
National Provider Identifier
1043321094
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD00031448 Issued in WA
Practice address
1100 9TH Ave
Seattle, WA 98101-2756
Phone
(206) 223-6600
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MD00031448 WA Primary

Addresses

Primary practice location

1100 9TH Ave
Seattle, WA 98101-2756

Mailing address

1100 9TH Ave
Ms M4-PA
Seattle, WA 98101-2756
Phone (206) 583-6025

Other identifiers 8

IdentifierTypeStateIssuer
8153769MedicaidWA
JA5907OtherWABLUE SHIELD
830005116OtherRAILROAD MEDICARE
US0899710OtherWAAETNA/USHC SPECIALIST
0039582OtherWALABOR & INDUSTRY
MD843WAOtherWAALASKA MEDICAID
804187200OtherWAIDAHO MEDICAID
US0818750OtherWAAETNA/USHC PCP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00031448WAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center- Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients

Locations

33501 1st Way S
Federal Way, WA 98003
Phone (253) 838-2400

1100 9th Ave
#M4
Seattle, WA 98101
Phone (206) 515-5811

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

Organizations & group practices 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1043321094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "address_2": "MS M4-PA",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-583-6025",
            "fax_number": "206-515-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-223-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "ANDREW",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WA",
            "license": "MD00031448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8153769",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "JA5907",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "830005116",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/USHC SPECIALIST",
            "identifier": "US0899710",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "0039582",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALASKA MEDICAID",
            "identifier": "MD843WA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO MEDICAID",
            "identifier": "804187200",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/USHC PCP",
            "identifier": "US0818750",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.