Active NPI
Tracy Jacobson, NP
- Family Nurse Practitioner
- Rockford, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209022392
- Practice address
- 6000 E State St Ste 1
Rockford, IL 61108-2521 - Phone
- (800) 427-1902
- NPI assigned
- Nov 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209022392 | IL | Primary |
Addresses
Primary practice location
6000 E State St Ste 1
Rockford, IL 61108-2521
Mailing address
333 N Summit St FL 15
Toledo, OH 43604-2615
Phone (800) 427-1902
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3505 N Bell School Rd
Rockford, IL 61114-6624
Phone (779) 696-0300
3535 N Bell School Rd
Regional Cancer Center
Rockford, IL 61114-6624
Phone (779) 696-9400
6824 Newburg Rd
Sa Valley
Rockford, IL 61108-4330
Phone (779) 696-7610
815 Marchesano Dr
Rockford, IL 61102-3521
Phone (779) 696-5950
Hospital & facility affiliations
- Uw Health
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.25 of 100
- Quality
- 80.59
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.91
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209022392 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swedishamerican Hospital | Current | Accepting new patients | |
| Swedishamerican Hospital | Current | Accepting new patients | |
| Swedishamerican Hospital | Current | Accepting new patients |
Locations
6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610
2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285
3535 N Bell School Rd
Rockford, IL 61114
Phone (779) 696-9400
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Rockford, IL
- NPI 1962451732
-
- Community/Retail Pharmacy
- Rockford, IL
- NPI 1306635982
-
- Family Medicine Physician
- Rochelle, IL
- NPI 1699011692
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1760542732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604880000000",
"number": "1114529781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 N SUMMIT ST FL 15",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436042615",
"telephone_number": "800-427-1902",
"fax_number": "419-531-2664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 E STATE ST STE 1",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611082521",
"telephone_number": "800-427-1902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "TRACY",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-09",
"last_updated": "2020-11-09",
"certification_date": "2020-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209022392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.