Brian Edwin Jacobson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

39343 Issued in CA

Practice address

500 Paseo Camarillo
Suite 105
Camarillo, CA 93010-5900

Phone

(805) 987-6851

NPI assigned

Sep 13, 2012

Sex

Male

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 CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• California Luna Care Physical Therapy PC

  • Physical Therapist
  • Los Gatos, CA
  • NPI 1689162166
  Medicare reassignment Care Compare group
• County of Ventura

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1629167457
  Medicare reassignment
• Dynamic Physical and Hand Therapy Inc

  • Physical Therapy Clinic/Center
  • Camarillo, CA
  • NPI 1376754051

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1093065336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 CINDY AVE",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913204421",
            "telephone_number": "951-660-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PASEO CAMARILLO",
            "address_2": "SUITE 105",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930105900",
            "telephone_number": "805-987-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "BRIAN",
        "middle_name": "EDWIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaa Home Care, Inc
• Dajonae Jackson
• Dez'Gillai Jackson
• Gary Jackson
• Wayne Harrison Jackson
• Pia Shari Jacoby
• Naser M Jamal, D.O.
• Mia Jamerson
• James a Kadin MD Inc
• James Yoo OD PC

• Physical Therapist in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.