Zachary Michael Jacobsen, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

10019614 Issued in OR

Practice address

900 Sunset Dr
La Grande, OR 97850-1387

Phone

(541) 963-8421

NPI assigned

Jan 2, 2024

Last updated

Jan 2, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in OR, ID2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grande Ronde Hospital IncGroup PAC ID 0547170789, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grande Ronde Hospital Hospital, La Grande, OR, CCN 381321

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grande Ronde Hospital, Inc.

  • Critical Access Hospital
  • La Grande, OR
  • NPI 1467446195
  Medicare reassignment Care Compare group NPD
• Teton Valley Health Care Inc

  dba Driggs Clinic

  • Rural Health Clinic/Center
  • Driggs, ID
  • NPI 1013264183
  Medicare reassignment
• Teton Valley Health Care Inc

  dba Teton Valley Health Care

  • Critical Access Hospital
  • Driggs, ID
  • NPI 1477809622
  Medicare reassignment
• Grande Ronde Hospital, Inc.

  dba Grande Ronde Hospital Urgent Care

  • Rural Health Clinic/Center
  • La Grande, OR
  • NPI 1093296519
  NPD

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

• Grande Ronde Hospital

  dba Grande Ronde Hospital Childrens Clinic

  • Pediatrics Physician
  • La Grande, OR
  • NPI 1861434615

  Hospital

  Care Compare affiliation
• Grande Ronde Hospital Inc.

  dba Grande Ronde Hospital Womens Clinic

  • Obstetrics & Gynecology Physician
  • La Grande, OR
  • NPI 1972545895

  Hospital

  Care Compare affiliation
• Grande Ronde Hospital, Inc.

  dba Grande Ronde Hospital Internal Medicine Clinic

  • Primary Care Clinic/Center
  • La Grande, OR
  • NPI 1174553929

  Hospital

  Care Compare affiliation
• Grande Ronde Hospital, Inc.

  • Critical Access Hospital
  • La Grande, OR
  • NPI 1467446195
  Care Compare affiliation

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1225808264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 IRA WAY",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "840759492",
            "telephone_number": "801-425-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SUNSET DR",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501387",
            "telephone_number": "541-963-8421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "ZACHARY",
        "middle_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "10019614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie Huxoll, BS
• Stacy E. Iles, DPM
• Indigo Counseling LLC
• David Burt Ingram, MD
• Leslie W Jackson, MD
• Jamie Jacobson
• James H Petersen MD PC
• James Michael Matthews MD PC
• James R Kopp M.D., P.C.
• James R Kopp MD PC

• Certified Registered Nurse Anesthetist in La Grande, OR
• Providers in La Grande, OR by specialty
• Certified Registered Nurse Anesthetist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.