Stuart I Jacobs, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

00G30790 Issued in CA

Practice address

5345 N El Dorado St
Ste 12
Stockton, CA 95207-5872

Phone

(209) 957-6662

Fax

(209) 957-0310

NPI assigned

Mar 31, 2006

Sex

Male

Sole proprietor

Yes

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 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

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1073574539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5345 N EL DORADO ST",
            "address_2": "STE 12",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075872",
            "telephone_number": "209-957-6662",
            "fax_number": "209-957-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5345 N EL DORADO ST",
            "address_2": "STE 12",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075872",
            "telephone_number": "209-957-6662",
            "fax_number": "209-957-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "STUART",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "00G30790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatiana Jackson
• Jesus Jacobo Jr.
• Luis Alejandro Jacobo, MS, ATC
• Pablo Jacobo, DDS
• Kaetlyn Macarri Jacobs
• Jacobson Dental Corp
• Daphne Marin Jacobson
• Jill Jacoy
• Jocelyn Jacques
• Mohammadreza Jafarishourijeh, FNP

• Dermatology Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.