Jacob Chacko, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

26484 Issued in AZ

Practice address

2055 W Hospital Dr Ste 205
Tucson, AZ 85704-7822

Phone

(520) 575-6944

Fax

(520) 575-1115

NPI assigned

Sep 25, 2006

Last updated

Nov 18, 2024By 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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ

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

Pulmonary DiseaseAlso: Internal Medicine

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013
• St Elizabeth Hospital Hospital, Fort Morgan, CO, CCN 060044

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.

• Yuma Regional Medical Center

  dba Onvida Health Yuma Medical Center

  • General Acute Care Hospital
  • Yuma, AZ
  • NPI 1194706655
  Medicare reassignment Care Compare group NPD
• Arizona Community Surgeons PC

  • Surgery Physician
  • Tucson, AZ
  • NPI 1689616070
  Medicare reassignment NPD
• Sound Physicians Intensivists of Arizona, Inc

  • Internal Medicine Physician
  • Tucson, AZ
  • NPI 1962944702
  Medicare reassignment NPD
• Yuma Regional Medical Center

  dba Onvida Health Yuma Medical Center

  • General Practice Physician
  • Yuma, AZ
  • NPI 1598993420
  NPD
• Valley ENT, PC

  • Otolaryngology Physician
  • Scottsdale, AZ
  • NPI 1508990185
  NPD (past)

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

• Yuma Regional Medical Center

  dba Onvida Health Yuma Medical Center

  • General Acute Care Hospital
  • Yuma, AZ
  • NPI 1194706655
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  dba St. Elizabeth Hospital

  • General Acute Care Hospital
  • Fort Morgan, CO
  • NPI 1881337392
  Care Compare affiliation

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1346340551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13627",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857323627",
            "telephone_number": "520-575-6944",
            "fax_number": "520-575-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 W HOSPITAL DR STE 205",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047822",
            "telephone_number": "520-575-6944",
            "fax_number": "520-575-1115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2851 S Avenue B Bldg 20",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853647726",
            "country_code": "US",
            "telephone_number": "928-336-2434",
            "fax_number": "928-336-2435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "26484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509961",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0874840",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1Z5260",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• June Jasmine Chabayta, MD
• Elizabeth Chabin, LCSW
• John P Chabin, MA, LPC
• Inderjit Chabra, MD, PHD
• Shalini Chabra, M.D.
• Eileen Lorraine Chacon, M.S., M.A.
• Vijaya Chada, MD
• Tyson Steven Chadaz, M.D.
• Abhimanyu Chadha
• Daniel P. Chafetz, NP

• Pulmonary Disease Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Pulmonary Disease Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.