Individual provider Active NPI

Jodi G Jacobson, LCSW DCSW

  • Social Worker
  • Boca Raton, FL
National Provider Identifier
1215929351
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW0002936 Issued in FL
Practice address
9250 Glades Rd Ste 209
Boca Raton, FL 33434
Phone
(561) 391-4669
Fax
(561) 391-1815
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW0002936 FL Primary

Addresses

Primary practice location

9250 Glades Rd Ste 209
Boca Raton, FL 33434

Mailing address

9250 Glades Rd Ste 209
Boca Raton, FL 33434-3958
Phone (561) 289-2573

Other practice location 1

9250 Glades Rd Ste 209
Boca Raton, FL 33434
Phone (561) 391-4669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111212000499 FL Practitioner - Clinical Social Worker 1052586526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9250 Glades Rd
Suite 209
Boca Raton, FL 33434-3958
Phone (561) 289-2573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW0002936FLMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jodi Jacobson, L.C.S.W., P.a. Social Worker CurrentSince Jul 31, 2017 Accepting new patients
Charles R Norris Jr MD PA Past Accepting new patients
Cesar L Benarroche MD PA PastSince Apr 28, 1999 Accepting new patients

Locations

9250 Glades Rd
Ste 209
Boca Raton, FL 33434
Phone (305) 932-5500

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1215929351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 GLADES RD STE 209",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343958",
            "telephone_number": "561-289-2573",
            "fax_number": "561-883-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 GLADES RD STE 209",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33434",
            "telephone_number": "561-391-4669",
            "fax_number": "561-391-1815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9250 Glades Rd Ste 209",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "33434",
            "country_code": "US",
            "telephone_number": "561-391-4669",
            "fax_number": "561-391-1815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "JODI",
        "middle_name": "G",
        "credential": "LCSW DCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW0002936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.