Mark Jacobs, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.1502 Issued in AL

Practice address

1541 Florida Ave Ste 305
Modesto, CA 95350-4439

Phone

(209) 575-5833

Fax

(209) 575-5836

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AL

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

Merit-based Incentive Payment System (MIPS)

Final score

85.6 of 100Reported as group

Quality

64.37

Promoting interoperability

100

Improvement activities

40

Cost

72.88

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.jacobs@marshfieldclinichealthsystem.cernerdirect.com

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.

• Baptist Health Centers, LLC

  • Health Service Clinic/Center
  • Winfield, AL
  • NPI 1265496236
  Medicare reassignment
• First Choice Physician Partners

  • Family Medicine Physician
  • Palm Springs, CA
  • NPI 1558797118
  NPD
• First Choice Physician Partners

  • Ophthalmology Physician
  • El Monte, CA
  • NPI 1912732892
  NPD
• Baptist Health Centers LLC

  • Specialist
  • Talladega, AL
  • NPI 1669436721
  NPD
• Michael J del Rio MD Inc

  • Surgical Critical Care Physician
  • Riverside, CA
  • NPI 1427253954
  NPD (past)
• Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Neillsville, WI
  • NPI 1619966793
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1346359866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0328",
            "fax_number": "502-588-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 FLORIDA AVE STE 305",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504439",
            "telephone_number": "209-575-5833",
            "fax_number": "209-575-5836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Abraham Flexner Way Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402023841",
            "country_code": "US",
            "telephone_number": "502-588-7600",
            "fax_number": "502-588-7700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "833 Princeton Ave SW Ste 200A",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352111321",
            "country_code": "US",
            "telephone_number": "205-786-2776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "MARK",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-01583",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.1502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1017889",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PA LICENSE",
            "identifier": "PA12419",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9500618500",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George I Jacob, D.C.
• Ana Jacobo
• Leslie Jacobo
• Christine Jacobs
• David Anton Jacobs Jr.
• Meriam Jacobs
• Stephen E. Jacobs, MD
• Youhana T Jacobs, MD
• Jacobson Dental Corp
• Cierra Jacobson

• Physician Assistant in Modesto, CA
• Providers in Modesto, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.