Paul Jacobsen, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD00026501 Issued in WA

Practice address

505 NE 87TH Ave
Ste. 460
Vancouver, WA 98664-1989

Phone

(360) 256-8865

Fax

(360) 256-7127

NPI assigned

Mar 27, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in WA

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

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.

• Peacehealth

  dba PeaceHealth Medical Group

  • Surgery Physician
  • Vancouver, WA
  • NPI 1609061969
  Medicare reassignment NPD
• Vancouver Neurologists PS

  • Neurology Physician
  • Vancouver, WA
  • NPI 1376503573
  NPD (past)

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273190400000",
    "number": "1255391819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 NE 87TH AVE",
            "address_2": "STE. 460",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641989",
            "telephone_number": "360-256-8865",
            "fax_number": "360-256-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NE 87TH AVE",
            "address_2": "STE. 460",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641989",
            "telephone_number": "360-256-8865",
            "fax_number": "360-256-7127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2010-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD00026501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8150039",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Marie Jacobe, QMHA
• Benjamin J Jacobs, MD
• Helen Marymae Jacobs, CDP
• Elizabeth Marta Jacobsen, LMFT
• Kanukayi Jacobsen
• Alicia May Jacobson, LLPN
• Bjorn Allan Jacobson, MD
• Gail H Jacobson, MD
• Jazmin Hope Jacobson I, LMHC
• Katherine Jacobson

• Neurology Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Neurology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2010; 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.