Individual provider Active NPI

Geraldine M Jacobson, MD

  • Radiation Oncology Physician
  • Tampa, FL
National Provider Identifier
1164423232
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ME50372 Issued in FL
Practice address
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone
(813) 745-7365
Fax
(813) 449-8618
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 34500 IA
Radiation Oncology Physician 2085R0001X 24703 WV
Radiation Oncology Physician 2085R0001X ME50372 FL Primary

Addresses

Primary practice location

12902 Usf Magnolia Dr
Tampa, FL 33612-9416

Mailing address

PO Box 9234
Morgantown, WV 26506-9234
Phone (304) 293-7227

Other practice location 1

1 Medical Center Dr
Morgantown, WV 26506-1200
Phone (304) 598-4000

Other identifiers 3

IdentifierTypeStateIssuer
44316OtherIAWELLMARK BCBS
3810022378MedicaidWV
0254359MedicaidIA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gjacobson17482@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address gjacobson17482@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231101002191 FL Practitioner - Radiation Oncology 7113829300

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88 of 100Reported as group
Quality
74.04
Promoting interoperability
100
Improvement activities
40
Cost
70.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34500IAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Radiation Oncology Past Accepting new patients
Bardmoor Cancer Center LLC Radiation Oncology PastSince Jul 16, 2001 Accepting new patients
West Virginia University Hospitals, Inc. PastSince Jan 12, 2012 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gerry.jacobson@direct.moffitt.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1164423232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9234",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265069234",
            "telephone_number": "304-293-7227",
            "fax_number": "304-598-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129416",
            "telephone_number": "813-745-7365",
            "fax_number": "813-449-8618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265061200",
            "country_code": "US",
            "telephone_number": "304-598-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "GERALDINE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IA",
            "license": "34500",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WV",
            "license": "24703",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME50372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "44316",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810022378",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0254359",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gjacobson17482@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medical Center Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265061200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gjacobson17482@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medical Center Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265061200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.