Individual provider Active NPI

Jeffrey M Jacobson, MD

  • Infectious Disease Physician
  • Philadelphia, PA
National Provider Identifier
1104808617
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD429023 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-3807
Fax
(215) 707-4414
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MD429023 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

11100 Euclid Ave
Cleveland, OH 44106-1716

Other identifiers 1

IdentifierTypeStateIssuer
01774987MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jeffreyjacobson@uhps.allscrptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061003000038 PA Practitioner - Infectious DiseasePractitioner - Internal Medicine 6608840657 Reassigns benefits to 2 organizations
I20190719000834 OH Practitioner - Infectious Disease 6608840657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136874NYMDMental Health Counselor
MD429023PAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc CurrentSince Jul 1, 2019 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Mar 9, 2019 Accepting new patients
Drexel University CurrentSince Jul 1, 2014 Accepting new patients
Drexel University CurrentSince Jul 1, 2014 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Drexel University Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Mar 9, 2019 Accepting new patients
Beth Israel Medical Center Infectious Disease Past Accepting new patients

Locations

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

11100 Euclid Ave
Cleveland Heights, OH 44106

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

1427 Vine St
Fl 8
Philadelphia, PA 19102
Phone (215) 762-6660

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

136 Diamond St
#C
Philadelphia, PA 19122
Phone (215) 426-8100

1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530

219 N Broad St
Fl 9
Philadelphia, PA 19107
Phone (215) 762-2688

219 N Broad St
Fl 5
Philadelphia, PA 19107
Phone (215) 762-6070

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

Interoperability endpoints

  • Direct secure messaging: jjacobson36179@ehrdirect.uhhospitals.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1104808617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3807",
            "fax_number": "215-707-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PA",
            "license": "MD429023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01774987",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeffreyjacobson@uhps.allscrptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "1110 Euclid Ave",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11100 Euclid Ave",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441061716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.