NPIMap

Individual provider Active NPI

Jacob Brekken, PA

  • Physician Assistant
  • Mason City, IA
National Provider Identifier
1346762341
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
88259 Issued in IA
Practice address
1010 4TH St SW Ste 105
Mason City, IA 50401-2856
Phone
(641) 428-7847
Fax
(641) 428-7999
NPI assigned
Jul 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 88259 IA Primary

Addresses

Primary practice location

1010 4TH St SW Ste 105
Mason City, IA 50401-2856

Mailing address

621 S Illinois Ave Ste 103
Mason City, IA 50401-5489

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jacob.Brekken@direct.2.mycarefile.org Direct MercyOne North Iowa

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20170815001785 IA Practitioner - Physician Assistant 7719259589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Iowa Mercy ClinicsGroup PAC ID 7810809076, 304 clinicians

Practice addresses (Care Compare)

1000 4TH St SW
Mason City, IA 50401-2800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.55 of 100Reported as group
Quality
73.89
Promoting interoperability
93
Improvement activities
40
Cost
70.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
88259IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Iowa Mercy Clinics CurrentSince Sep 1, 2017 Accepting new patients
North Iowa Mercy Clinics CurrentSince Sep 1, 2017 Accepting new patients
North Iowa Mercy Clinics Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

621 S Illinois Ave
Ste 103
Mason City, IA 50401

1010 4th St SW
Ste 105
Mason City, IA 50401
Phone (641) 422-7847

1000 4th St SW
Mason City, IA 50401
Phone (641) 424-6704

Interoperability endpoints

  • Direct secure messaging: jacob.brekken@direct.2.mycarefile.org
  • Direct secure messaging: jbrekken3926079@direct.trinity-health.org

Organizations & group practices 5

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 1

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": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1346762341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S ILLINOIS AVE STE 103",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504015489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 4TH ST SW STE 105",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012856",
            "telephone_number": "641-428-7847",
            "fax_number": "641-428-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREKKEN",
        "first_name": "JACOB",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-11",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "88259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jacob.Brekken@direct.2.mycarefile.org",
            "affiliation": "Y",
            "endpointDescription": "Direct Email Address",
            "affiliationName": "MercyOne North Iowa",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1010 4th St SW Ste 105",
            "city": "Mason City",
            "state": "IA",
            "country_code": "US",
            "postal_code": "504012856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

Verify at the official NPI Registry.