Jonathan M. Jacobs, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

174853 Issued in NY

Practice address

5100 W Taft Rd
Suite 2a
Liverpool, NY 13088-3807

Phone

(315) 452-2555

Fax

(315) 452-2559

NPI assigned

Aug 17, 2005

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 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• St. Josephs Imaging Associates PLLC

  • Diagnostic Radiology Physician
  • Liverpool, NY
  • NPI 1093709180
  Medicare reassignment NPD
• Prospect Hill Radiology Group P C

  • Diagnostic Radiology Physician
  • Syracuse, NY
  • NPI 1235122425
  Medicare reassignment
• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  NPD (past)

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1114919917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 CROSSROADS PARK DR",
            "address_2": "2ND FLOOR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883589",
            "telephone_number": "315-295-2100",
            "fax_number": "315-295-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 2A",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-452-2555",
            "fax_number": "315-452-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JONATHAN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "174853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01428151",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David John Isabella, DC
• Rachel Jennifer Isabelle, FNP-BC
• Ayman Iskander, MD
• Clifford Lawrence Ivers, PHD
• Nickolas Izzo, PA
• Kahsenniiostha Jacobs
• Jana Dosztan-Reiss, Inc.
• James Hyuk-Jae Jang, D.D.S.
• Christa M Jeavons, FNP
• Jennifer a. Crider, LCSW, PLLC

• Diagnostic Radiology Physician in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.