NPIMap

Individual provider Active NPI

Kirk Douglas Jacobson, M.D.

  • Internal Medicine Physician
  • Eugene, OR
National Provider Identifier
1093707366
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD09759 Issued in OR
Practice address
1488 Oak St
Eugene, OR 97401-4043
Phone
(541) 431-0000
Fax
(541) 344-6176
NPI assigned
Aug 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD09759 OR Primary

Addresses

Primary practice location

1488 Oak St
Eugene, OR 97401-4043

Mailing address

1488 Oak St
Eugene, OR 97401-4043
Phone (541) 431-0000

Other identifiers 1

IdentifierTypeStateIssuer
237990MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090116000475 OR Practitioner - Internal Medicine 5092878058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oregon Health Sciences University School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Praxis Health PCGroup PAC ID 8325941446, 174 clinicians

Practice addresses (Care Compare)

1426 Oak St
Eugene, OR 97401-4043
Phone (541) 431-0000

1488 Oak St
Eugene, OR 97401-4043
Phone (541) 431-0000

354 W Adams Ave
Sisters, OR 97759-2619
Phone (541) 549-9609

Hospital & facility affiliations

  • Sacred Heart Home Health Home health agency, Springfield, OR, CCN 387023
  • Signature Healthcare at Home Home health agency, Eugene, OR, CCN 387140
  • Mission Home Health of Salem Home health agency, Salem, OR, CCN 387108
  • Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102
  • Peace Harbor Medical Center Hospital, Florence, OR, CCN 381316
  • Peacehealth Cottage Grove Community Medical Center Hospital, Cottage Grove, OR, CCN 381301
  • McKenzie-Willamette Medical Center Hospital, Springfield, OR, CCN 380020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue14
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Praxis Health, PC Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Praxis Health, PC CurrentSince Jul 1, 2016 Accepting new patients

Locations

1426 Oak St
Eugene, OR 97401
Phone (541) 431-0000

1488 Oak St
Eugene, OR 97401
Phone (541) 431-0000

Interoperability endpoints

  • Direct secure messaging: kjacobso@yourcarecommunity.org

Organizations & group practices 2

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 8

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": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1093707366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 OAK ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014043",
            "telephone_number": "541-431-0000",
            "fax_number": "541-344-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 OAK ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014043",
            "telephone_number": "541-431-0000",
            "fax_number": "541-344-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "KIRK",
        "middle_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD09759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "237990",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.