Jacob Darrell Jensen, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A-2047-17 Issued in NM

Practice address

Unm Department of Emergency Medicine-Msc11 6025
1 University of New Mexico
Albuquerque, NM 87131-0001

Phone

(505) 272-5062

NPI assigned

Jul 11, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Emergency Medicine

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Madison Memorial HospitalGroup PAC ID 4183949522, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Madison Memorial Hospital Hospital, Rexburg, ID, CCN 130025

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jensenja@direct.madisonmemorial.org
• FHIR API: https://fhir-myrecord.cerner.com/r4/d61ab3e4-55bb-4859-99e6-22c413b48f2a/

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.

• Madison Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Rexburg, ID
  • NPI 1346643038
  Medicare reassignment Care Compare group NPD
• Minidoka Memorial Hospital

  • Critical Access Hospital
  • Rupert, ID
  • NPI 1679553531
  Medicare reassignment NPD
• Teton Valley Health Care Inc

  • Rural Health Clinic/Center
  • Driggs, ID
  • NPI 1013264183

  Family Medicine

  Medicare reassignment NPD
• Madison Co Memorial Hospital

  • General Acute Care Hospital
  • Rexburg, ID
  • NPI 1992747570
  NPD
• Teton Valley Health Care, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Driggs, ID
  • NPI 1053669598
  NPD
• Minidoka Memorial Hospital

  • Emergency Care Clinic/Center
  • Rupert, ID
  • NPI 1134333495

  Emergency Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Madison Co Memorial Hospital

  • Obstetrics & Gynecology Physician
  • Rexburg, ID
  • NPI 1073154266

  Hospital

  Care Compare affiliation
• Madison Co Memorial Hospital

  • General Acute Care Hospital
  • Rexburg, ID
  • NPI 1992747570
  Care Compare affiliation

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1215292669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNMMG",
            "address_2": "933 BRADBURY SE, SUITE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87106",
            "telephone_number": "505-272-3120",
            "fax_number": "505-272-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNM DEPARTMENT OF EMERGENCY MEDICINE-MSC11 6025",
            "address_2": "1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-5062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Osf St Francis Medical Ctr",
            "address_2": "530 NE Glen Oak Ave, SFNB 2624",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "309-655-6710",
            "fax_number": "309-624-9887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1224 8th St",
            "address_purpose": "LOCATION",
            "city": "Rupert",
            "state": "ID",
            "postal_code": "833501599",
            "country_code": "US",
            "telephone_number": "208-436-0481",
            "fax_number": "208-436-6038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "JACOB",
        "middle_name": "DARRELL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125065738",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "O-1304",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "A-2047-17",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICINE LICENSING BOARD",
            "identifier": "O-1304",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM BOARD OF OSTEOPATHIC MEDICINE",
            "identifier": "A-2047-17",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Jennings
• Jenny'S Caring Hands LLC
• Barbara Lynn Jensen
• Clare Lizbeth Jensen, LMHC
• Craig A Jensen, MD
• Johnathan Patrick Jensen, MD
• Karlyn Jensen, PHARMD
• Max Benjamin Jensen, CNP
• Paige Beven Jensen, R.D.H., M.S.
• Peter Marshall Jensen, D.D.S.

• Emergency Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Emergency Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.