Justin Brian Jacobs

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

28555 Starbright Blvd Ste B
Perrysburg, OH 43551-5662

Phone

(419) 931-3030

Fax

(419) 931-3046

NPI assigned

Sep 29, 2019

Last updated

Feb 24, 2020By 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 OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health Physicians-North LLCGroup PAC ID 2668522400, 131 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohioans Home Healthcare, Inc Home health agency, Perrysburg, OH, CCN 368247
• Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
• Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259
• Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjacobs700841@direct.bsmhealth.org

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.

• Mercy Health Physicians-North LLC

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1609000769
  Medicare reassignment Care Compare group NPD
• Mercy Health Physicians North Specialty Care LLC

  • Surgery Physician
  • Toledo, OH
  • NPI 1306468418
  Medicare reassignment
• Mercy Health Physicians - North, LLC

  dba Mercy Health - Perrysburg Podiatry

  • Customized Equipment (DME)
  • Perrysburg, OH
  • NPI 1992358766
  NPD
• Mercy Health Physicians North Specialty Care LLC

  • Customized Equipment (DME)
  • Toledo, OH
  • NPI 1235891672
  NPD

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

• Bay Park Community Hospital

  • General Acute Care Hospital
  • Oregon, OH
  • NPI 1598765539
  Care Compare affiliation
• Mercy Health - St Vincent Medical Center LLC

  dba Mercy Health St Vincent Medical Center

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1467493551
  Care Compare affiliation
• Ohioans Home Healthcare, Inc

  • Home Health Agency
  • Perrysburg, OH
  • NPI 1093836546
  Care Compare affiliation
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Care Compare affiliation
• Toledo Hospital

  dba ProMedica Transportation Network

  • Ambulance
  • Toledo, OH
  • NPI 1427147339

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1569715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1316588544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28555 STARBRIGHT BLVD STE B",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515662",
            "telephone_number": "419-931-3030",
            "fax_number": "419-931-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28555 STARBRIGHT BLVD STE B",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515662",
            "telephone_number": "419-931-3030",
            "fax_number": "419-931-3046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JUSTIN",
        "middle_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-29",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Hutchins
• Intermed Associates, Inc
• Internal Medicine Consultants of Northwest Ohio LTD
• Mahir Isho
• J. Scott Stewart, O.D.
• Cori L Jacobson, CNM
• Emily Marie Jaeger
• Shatha Jajou
• James P. Stupak, D.C., PLC
• James R. Hennessy, M.D.

• Physician Assistant in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.