Eric Dudley Jacobson, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G63250 Issued in CA

Practice address

809 West Stetson Avenue Suite B
Apex Radiology Medical Group, Inc
Hemet, CA 92543

Phone

(951) 537-6002

NPI assigned

Jun 16, 2006

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

Other identifiers 6

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

Specialty

Diagnostic Radiology

Education

Uniformed Services Uhs Fe Hebert School of Med, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seven Star Hospital Associates IncGroup PAC ID 4789083338, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hemet Global Medical Center Hospital, Hemet, CA, CCN 050390
• Menifee Global Medical Center Hospital, Sun City, CA, CCN 050684
• Kaiser Foundation Hospital-Moreno Valley Hospital, Moreno Valley, CA, CCN 050765

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Seven Star Hospital Associates Inc.

  • Diagnostic Radiology Physician
  • Hemet, CA
  • NPI 1043813140
  Medicare reassignment Care Compare group NPD
• Hemet Radiology Medical Group, Inc.

  • Specialist
  • Hemet, CA
  • NPI 1619943537

  Diagnostic Radiology

  NPD (past)
• Hemet Valley Medical Center

  • General Acute Care Hospital
  • Hemet, CA
  • NPI 1508939349
  NPD (past)
• Menifee Valley Medical Center

  • General Acute Care Hospital
  • Sun City, CA
  • NPI 1881781482
  NPD (past)
• Renaissance Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Rancho Cucamonga, CA
  • NPI 1134200983
  NPD (past)

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

• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • Moreno Valley, CA
  • NPI 1174793459
  Care Compare affiliation
• KPC Global Medical Centers, Inc.

  • General Acute Care Hospital
  • Hemet, CA
  • NPI 1114239068
  Care Compare affiliation
• KPC Global Medical Centers, Inc.

  • General Acute Care Hospital
  • Sun City, CA
  • NPI 1467764308
  Care Compare affiliation

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1093759151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 WEST STETSON AVENUE",
            "address_2": "SUITE B",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "92543",
            "telephone_number": "951-537-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 WEST STETSON AVENUE SUITE B",
            "address_2": "APEX RADIOLOGY MEDICAL GROUP, INC",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "92543",
            "telephone_number": "951-537-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ERIC",
        "middle_name": "DUDLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G63250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00G632502",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "300116435",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00G632501",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "300116419",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "300116433",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G632500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Breanna Jackson
• Mya Jackson
• Tori Consuelo Jackson, RAS
• Natalia Evgenievna Jacobs, MD
• Arthur Jacobson, M.D.
• A Kareem Jaffer, MD
• Jaimes & Co. Healthcare Services
• Marcelina Jaimes, NP
• Muldith Jallah
• Jamal Dental Corporation

• Diagnostic Radiology Physician in Hemet, CA
• Providers in Hemet, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; 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.