Greta Jacobsen

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A184055 Issued in CA

Practice address

2021 Santa Monica Blvd Ste 625E
Santa Monica, CA 90404-2169

Phone

(310) 829-8948

Fax

(424) 212-5937

NPI assigned

May 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Home Health la County South Home health agency, Torrance, CA, CCN 557447
• Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290

Merit-based Incentive Payment System (MIPS)

Final score

90.42 of 100Reported as group

Quality

96.07

Promoting interoperability

100

Improvement activities

40

Cost

71.98

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Providence Saint Johns Medical Foundation

  • Specialist
  • Santa Monica, CA
  • NPI 1770093734

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Providence Saint Johns Medical Foundation

  • Family Medicine Physician
  • Santa Monica, CA
  • NPI 1518438712
  NPD
• Providence Saint John'S Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  NPD (past)
• Saint John'S Health Clinic

  • Specialist
  • Santa Monica, CA
  • NPI 1336438902
  NPD (past)

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

• Providence Health System - Southern California

  • Home Health Agency
  • Torrance, CA
  • NPI 1700890514
  Care Compare affiliation
• Providence Saint John'S Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  Care Compare affiliation

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1255952941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 E HERNDON AVE STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203306",
            "telephone_number": "559-450-4637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD STE 625E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042169",
            "telephone_number": "310-829-8948",
            "fax_number": "424-212-5937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1313 E Herndon Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937203306",
            "country_code": "US",
            "telephone_number": "559-450-4637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "GRETA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-04",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A184055",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Hattenbach DO Inc
• Arash Jacob, D.O.
• Lauren A Jacob, L.AC.
• Naomi Jacobs-El, DPT, LMT, RYT, CPT
• Jeffrey Rolnald Jacobs
• Wendy Jacobsohn, D.C.
• Randy F. Jacobson, P.T.
• Alexis Jacques, SLP
• Jessica Siham Jaddaoui
• Kamron Jafari, L.AC.

• Family Medicine Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.