Individual provider Active NPI

Erik Andrew Jacobson, M.D.

  • Diagnostic Radiology Physician
  • Albany, NY
National Provider Identifier
1114389897
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
315122-01 Issued in NY
Practice address
47 New Scotland Ave
Albany, NY 12208-3412
Phone
(518) 262-3277
NPI assigned
Mar 22, 2016
Last updated
Apr 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Diagnostic Radiology Physician 2085R0202X MED-PHYS-LIC-117675 MT
Diagnostic Radiology Physician 2085R0202X 315122-01 NY Primary

Addresses

Primary practice location

47 New Scotland Ave
Albany, NY 12208-3412

Mailing address

47 New Scotland Ave
Albany, NY 12208-3412

Other practice location 1

310 Sunnyview Ln
Kalispell, MT 59901-3129
Phone (406) 858-6219

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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

Enrollment IDStateProvider typePAC IDDetails
I20230703002836 MT Practitioner - Diagnostic Radiology 2769727536 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Washington School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Community HospitalGroup PAC ID 5496659567, 59 clinicians
Liberty County Hospital and Nursing Home IncGroup PAC ID 0042128480, shared by 3 NPIs, 26 clinicians
Northwest Imaging, PCGroup PAC ID 8426969155, 18 clinicians
Logan Health - ShelbyGroup PAC ID 6608285192, 23 clinicians
Logan Health - ConradGroup PAC ID 8921917501, 25 clinicians

Practice addresses (Care Compare)

107 6TH Ave SW
Ronan, MT 59864-2634
Phone (406) 676-4441

310 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 751-6488

315 W Madison Ave
Chester, MT 59522-7801
Phone (406) 759-5181

320 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 751-7519

640 Park Ave
Shelby, MT 59474-1663
Phone (406) 434-3200

802 2ND St SE
Cut Bank, MT 59427-3329
Phone (406) 873-2251

805 Sunset Blvd
Conrad, MT 59425-1717
Phone (406) 271-3211

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MED-PHYS-LIC-117675MTMDDiagnostic Radiology Physician
315122-01NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty County Hospital and Nursing Home, Inc Current Accepting new patients
Kalispell Regional Medical Center, Inc CurrentSince Jul 31, 2023 Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
St. Lukes Community Hospital Current Accepting new patients
St Lukes Community Hospital CurrentSince Aug 30, 2023 Accepting new patients
Northwest Imaging, PC Diagnostic Radiology CurrentSince Jul 31, 2023 Accepting new patients
Logan Health - Conrad Current Accepting new patients
Logan Health - Shelby Current Accepting new patients
Liberty County Hospital and Nursing Home, Inc CurrentSince Apr 1, 2025 Accepting new patients
St Lukes Community Hospital CurrentSince Aug 30, 2023 Accepting new patients
Northern Rockies Medical Center, Inc. CurrentSince Feb 1, 2025 Accepting new patients
Glacier Regional Pathology, LTD. Current Accepting new patients
Logan Health - Conrad CurrentSince Nov 1, 2025 Accepting new patients
Logan Health - Shelby CurrentSince Sep 1, 2025 Accepting new patients
Logan Health - Conrad CurrentSince Nov 1, 2025 Accepting new patients
Northern Rockies Medical Center, Inc. Current Accepting new patients
Kalispell Regional Medical Center, Inc. CurrentSince Jul 31, 2023 Accepting new patients

Locations

805 Sunset Blvd
Conrad, MT 59425
Phone (406) 271-3211

809 Sunset Blvd
Conrad, MT 59425
Phone (406) 271-3211

802 2nd St SE
Cut Bank, MT 59427
Phone (406) 873-2251

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

320 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 752-7441

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

107 6th Ave SW
Ronan, MT 59864
Phone (406) 676-3600

126 6th Ave SW
Ronan, MT 59864
Phone (406) 676-3600

640 Park Ave
Shelby, MT 59474
Phone (406) 434-3200

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 11

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1114389897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-3277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Sunnyview Ln",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013129",
            "country_code": "US",
            "telephone_number": "406-858-6219",
            "fax_number": "406-758-3232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ERIK",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MT",
            "license": "MED-PHYS-LIC-117675",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "315122-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center, Inc",
            "address_1": "310 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.