NPIMap

Individual provider Active NPI

David Alexander Jacoby, MD

  • Internal Medicine Physician
  • San Carlos, CA
National Provider Identifier
1295715134
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G27649 Issued in CA
Practice address
1036 Laurel St
San Carlos, CA 94070
Phone
(650) 631-7000
Fax
(650) 631-2309
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G27649 CA Primary

Addresses

Primary practice location

1036 Laurel St
San Carlos, CA 94070

Mailing address

1036 Laurel St
San Carlos, CA 94070
Phone (650) 631-7000

Other identifiers 1

IdentifierTypeStateIssuer
011912530OtherCARAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address davidjacoby@3325485645828.direct.elationemr.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080318000470 CA Practitioner - Internal Medicine 7012093933 Practice locations: San Carlos, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1036 Laurel St
San Carlos, CA 94070-3919
Phone (650) 631-7000

Hospital & facility affiliations

  • Pathways Home Health and Hospice Home health agency, Sunnyvale, CA, CCN 057190
  • Sequoia Hospital Hospital, Redwood City, CA, CCN 050197
  • Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007
  • Stanford Health Care Hospital, Stanford, CA, CCN 050441

Merit-based Incentive Payment System (MIPS)

Final score
21.19 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
70.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G27649CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sequoia Health Services Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: davidjacoby@3325485645828.direct.elationemr.com
  • Direct secure messaging: david.jacoby@3325485645828.direct.elationemr.com

Organizations & group practices 1

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1295715134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 LAUREL ST",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "94070",
            "telephone_number": "650-631-7000",
            "fax_number": "650-631-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 LAUREL ST",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "94070",
            "telephone_number": "650-631-7000",
            "fax_number": "650-631-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "DAVID",
        "middle_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2021-11-29",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G27649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "011912530",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "davidjacoby@3325485645828.direct.elationemr.com",
            "affiliation": "N",
            "address_1": "1036 Laurel St",
            "city": "San Carlos",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

Verify at the official NPI Registry.