Individual provider Active NPI

Jacob Kjelland, MD

  • Hematology & Oncology Physician
  • Travis Afb, CA
National Provider Identifier
1043604606
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A145633 Issued in CA
Practice address
101 Bodin Cir
Travis Afb, CA 94535-1800
Phone
(707) 423-5129
NPI assigned
Mar 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X MD70092051 WA
Internal Medicine Physician 207R00000X A145633 CA
Hematology & Oncology Physician 207RH0003X A145633 CA Primary

Addresses

Primary practice location

101 Bodin Cir
Travis Afb, CA 94535-1800

Mailing address

101 Bodin Cir
Travis Afb, CA 94535-1809
Phone (707) 423-5129

Other practice location 1

834 Sheridan St
Port Townsend, WA 98368-2443
Phone (360) 344-3091

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
I20231013001685 CA Practitioner - Hematology/Oncology 3072880541 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Eastern Virginia Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northbay Physicians Surgery Center, LLCGroup PAC ID 0042122244, 336 clinicians
Northbay Health Medical FoundationGroup PAC ID 3274010871, 207 clinicians

Practice addresses (Care Compare)

1020 Nut Tree Rd
Suite 390
Vacaville, CA 95687-4100
Phone (707) 624-8000

Hospital & facility affiliations

  • Northbay Medical Center Hospital, Fairfield, CA, CCN 050367

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A145633CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Health Medical Foundation Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Northbay Healthcare Group CurrentSince Oct 24, 2023 Accepting new patients
Northbay Healthcare Group CurrentSince Oct 24, 2023 Accepting new patients
Northbay Physicians Surgery Center LLC Past Accepting new patients

Locations

4500 Business Center Dr
Fairfield, CA 94534
Phone (707) 646-4777

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

101 Bodin Cir
Travis AFB, CA 94535
Phone (707) 423-3000

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

1010 Nut Tree Rd
Ste 100B
Vacaville, CA 95687
Phone (707) 646-7999

1020 Nut Tree Rd
#390
Vacaville, CA 95687
Phone (707) 624-8000

1020 Nut Tree Rd
Ste 390
Vacaville, CA 95687
Phone (707) 624-8000

1020 Nut Tree Rd
#190
Vacaville, CA 95687
Phone (707) 624-8100

101 Main St
Winters, CA 95694
Phone (530) 795-4123

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/UMZ-Uxn6V9x08sH5gCnG-5yPg9ZX7et6/

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1426982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1043604606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-5129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351800",
            "telephone_number": "707-423-5129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "834 Sheridan St",
            "address_purpose": "LOCATION",
            "city": "Port Townsend",
            "state": "WA",
            "postal_code": "983682443",
            "country_code": "US",
            "telephone_number": "360-344-3091",
            "fax_number": "360-344-3082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KJELLAND",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-22",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WA",
            "license": "MD70092051",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A145633",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A145633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Travis Afb, CA

Sources for this page

Verify at the official NPI Registry.