Bradly P Jacobs, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A60433 Issued in CA

Practice address

601 Murray Circle
Sausalito, CA 94965

Phone

(415) 339-2692

Fax

(415) 339-2691

NPI assigned

Apr 26, 2006

Sex

Male

Sole proprietor

Yes

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 CA

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

State licenses

Practice roles

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.

• Marin Hospitalist Medical Group, Inc.

  • Internal Medicine Physician
  • Greenbrae, CA
  • NPI 1023041753
  NPD (past)
• San Francisco Emergency Medical Associates

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1134110661
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1184680258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MURRAY CIRCLE",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "94965",
            "telephone_number": "415-339-2692",
            "fax_number": "415-339-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MURRAY CIRCLE",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "94965",
            "telephone_number": "415-339-2692",
            "fax_number": "415-339-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "BRADLY",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A60433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A604330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Devatara J. Holman, MS, MA, LAC
• Cassandra Renee Howard, MSOT, OTR/L
• Tatiana Eloisa Huezo, FNP-C
• Edward Jay Hyman, PH.D.
• Jennifer Beth Jackson, L.AC.
• Jet Physio Sports Physical Therapy Inc.
• Pamela Johnson, PT
• Gradia Carolyn Junius
• Karen Lise Junker, MDIV
• Jeffrey James Kacirk, D.C.

• Internal Medicine Physician in Sausalito, CA
• Providers in Sausalito, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.