Alexandra Jacoby, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209018617 Issued in IL

Practice address

9977 Woods Dr
Skokie, IL 60077-1057

Phone

(847) 733-5707

NPI assigned

Jan 27, 2019

Last updated

Oct 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

84.9 of 100Reported as group

Quality

75.91

Promoting interoperability

99

Improvement activities

40

Cost

74.6

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  NPD

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

{
    "created_epoch": "1548547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1184188807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "224-364-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "847-733-5707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "ALEXANDRA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-27",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041418765",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajacoby270902@direct.northshore.org",
            "affiliation": "N",
            "address_1": "9977 Woods Dr",
            "city": "Skokie",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600771057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chinwe Izuakor
• Constantin Izvanariu, D.D.S.
• Jan Jacher
• Bryan Jacobs, DMD, MS
• Rhea Jacobson, P.T.
• Ann M Jacott, P.T.
• Dhanpal H Jain
• Vandana Jain, MD
• Andrea Jennifer Jalloh
• Mohammed A Jameel, MD

• Family Nurse Practitioner in Skokie, IL
• Providers in Skokie, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.

Verify at the official NPI Registry.