Active NPI
Joanne Frances Jacobson, MD
- Anesthesiology Physician
- San Mateo, CA
National Provider Identifier
1215073572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G52210
- Practice address
- 66 Bovet Rd
Ste 103
San Mateo, CA 94402-3125 - Phone
- (650) 570-0500
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G52210 | CA | Primary |
Addresses
Primary practice location
66 Bovet Rd
Ste 103
San Mateo, CA 94402-3125
Mailing address
PO Box 7793
San Francisco, CA 94120-7793
Phone (925) 951-1366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G522100 | Medicaid | CA |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071116000376 | CA | Practitioner - Anesthesiology | 1355439845 | Practice locations: Greenbrae, CA; Pinole, CA; Pleasanton, CA; San Francisco, CA; San Ramon, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G52210 | CA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215073572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7793",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941207793",
"telephone_number": "925-951-1366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 BOVET RD",
"address_2": "STE 103",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944023125",
"telephone_number": "650-570-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "JOANNE",
"middle_name": "FRANCES",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G52210",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G522100",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.