Active NPI
Leonard S Jacobs, M.D.
- Psychiatry Physician
- Kailua, HI
National Provider Identifier
1154421170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 02098
- Practice address
- 970 N Kalaheo Ave
Suite A322
Kailua, HI 96734-1801 - Phone
- (808) 254-5385
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 02098 | HI | Primary |
Addresses
Primary practice location
970 N Kalaheo Ave
Suite A322
Kailua, HI 96734-1801
Mailing address
40 Kai One PL Apt C
Kailua, HI 96734-2159
Phone (808) 254-5385
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35782 | Other | HI | HMSA |
| 03235002 | Medicaid | HI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02098 | HI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154421170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 KAI ONE PL APT C",
"city": "KAILUA",
"state": "HI",
"postal_code": "967342159",
"telephone_number": "808-254-5385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "970 N KALAHEO AVE",
"address_2": "SUITE A322",
"city": "KAILUA",
"state": "HI",
"postal_code": "967341801",
"telephone_number": "808-254-5385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "LEONARD",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "HI",
"license": "02098",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA",
"identifier": "35782",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03235002",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kailua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.