Dan G. Jacobson, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME0036695 Issued in FL

Practice address

2960 NE Heather CT
Jensen Beach, FL 34957-5066

Phone

(772) 285-9665

Fax

(772) 334-7232

NPI assigned

May 24, 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 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1194728170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 NE HEATHER CT",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349575066",
            "telephone_number": "772-285-9665",
            "fax_number": "772-334-7232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 NE HEATHER CT",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349575066",
            "telephone_number": "772-285-9665",
            "fax_number": "772-334-7232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "DAN",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME0036695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKMANS COMP",
            "identifier": "ME0036695",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL AND NETWORK BLUE",
            "identifier": "01280",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066502900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Hunter, APRN, WHNP-BC
• Rachel J Hypolite, NCC, LMHC
• Interventional Rehabilitation of South Florida, Inc
• Cynthia Irish, SLP
• Christy Tunnell Jackson, PT
• Lorraine Jagodowski, RPT
• Jacinta James, MS, BCBA
• Amy Lynne Janicki, MS-CCC-SLP
• Sara Jansen
• Alexandra Jansson

• Gastroenterology Physician in Jensen Beach, FL
• Providers in Jensen Beach, FL by specialty
• Gastroenterology Physician in Florida

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

Verify at the official NPI Registry.