Individual provider Active NPI

Sandra M Jacobson, RD

  • Registered Dietitian
  • Tucson, AZ
National Provider Identifier
1336897263
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86020648 Issued in AZ
Practice address
320 W Prince Rd
Tucson, AZ 85705-3526
Phone
(520) 670-3909
Fax
(520) 309-2560
NPI assigned
Mar 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86020648 AZ Primary

Addresses

Primary practice location

320 W Prince Rd
Tucson, AZ 85705-3526

Mailing address

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 670-3909

Other practice location 1

1230 S Cherrybell Stra
Tucson, AZ 85713-1907
Phone (520) 670-3909

Other identifiers 1

IdentifierTypeStateIssuer
86020648OtherAZCOMMISSION ON DIETETIC REGISTRATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220531002144 AZ Practitioner - Registered Dietitian Or Nutrition Professional 1557749777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Rio Santa Cruz Neighborhood Health Center, Inc.Group PAC ID 6305739244, 283 clinicians

Practice addresses (Care Compare)

1500 W Commerce CT
Tucson, AZ 85746-6031
Phone (520) 670-3909

320 W Prince Rd
Tucson, AZ 85705-3526
Phone (520) 670-3909

7490 S Camino de Oeste
Tucson, AZ 85746-9308
Phone (520) 670-3909

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 670-3909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86020648AZMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince May 1, 2022 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince May 1, 2022 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc Past Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc Past Accepting new patients

Locations

3655 E Grant Rd
Tucson, AZ 85716
Phone (520) 440-6323

434 E University Blvd
Ste 100
Tucson, AZ 85705
Phone (520) 309-4250

434 E University Blvd
Ste 200
Tucson, AZ 85705

1500 W Commerce Ct
Bldg 1
Tucson, AZ 85746
Phone (520) 309-3006

225 W Irvington Rd
Tucson, AZ 85714
Phone (520) 670-3857

320 W Prince Rd
Tucson, AZ 85705
Phone (520) 838-7663

3950 S Country Club Rd
Ste 130
Tucson, AZ 85714
Phone (520) 874-2778

6950 E Golf Links Rd
Tucson, AZ 85730
Phone (520) 309-3250

1230 S Cherrybell Stra
Tucson, AZ 85713
Phone (520) 310-7316

7490 S Camino de Oeste
Tucson, AZ 85746
Phone (520) 879-6039

839 W Congress St
Tucson, AZ 85745
Phone (520) 670-3707

4550 S Palo Verde Rd
Bldg 1
Tucson, AZ 85714

101 W Irvington Rd
Bldg 3C
Tucson, AZ 85714
Phone (520) 573-0096

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1336897263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W PRINCE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857053526",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1230 S Cherrybell Stra",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857131907",
            "country_code": "US",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "SANDRA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-10",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "86020648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "86020648",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.