NPIMap

Individual provider Active NPI

Mikael James Jacobson, M.D.

  • Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1356364384
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
L5386 Issued in TX
Practice address
8550 Huebner Rd
San Antonio, TX 78240-1803
Phone
(210) 541-5300
NPI assigned
Jul 25, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X L5386 TX Primary

Addresses

Primary practice location

8550 Huebner Rd
San Antonio, TX 78240-1803

Mailing address

8111 Mainland Dr
Suite 104448
San Antonio, TX 78240-3748
Phone (210) 363-5471

Other identifiers 7

IdentifierTypeStateIssuer
164124306MedicaidTX
8S7470OtherTXBCBS PROVIDER #
175829401OtherTXTMHP
551369OtherTXVALUE OPTIONS #
L5386OtherTXTEXAS STATE LICENSE #
202949040OtherTXTRICARE PROVIDER ID
8DJ721OtherTXBCBSTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040505001406 TX Practitioner - Psychiatry 4385632439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical School at San Antonio, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mypsych Mental Health, PLLCGroup PAC ID 5890078042, 14 clinicians

Practice addresses (Care Compare)

8026 Floyd Curl Dr
San Antonio, TX 78229-3915
Phone (210) 990-1142

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mypsych Mental Health, PLLC Psychiatry CurrentSince Jan 7, 2017 Accepting new patients
Methodist Healthcare System of San Antonio, LTD., L.L.P. Past Accepting new patients
Methodist Healthcare System of San Antonio, LTD., L.L.P. Past Accepting new patients
Methodist Inpatient Management Group Past Accepting new patients
Edulfo Gonzalez, M.D., PLLC Psychiatry PastSince Mar 12, 2023 Accepting new patients
Mikael Jacobson, M.D., P.a. Psychiatry PastSince Sep 10, 2005 Accepting new patients
Enlightened Behavioral Health Systems, L.L.C. PastSince Jun 19, 2010 Accepting new patients
Psychiatric Inpatient Management Services, PLLC Psychiatry Past Accepting new patients

Locations

8026 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-8110

8407 Bandera Rd
Ste 103
San Antonio, TX 78250
Phone (210) 549-8071

8550 Huebner Rd
San Antonio, TX 78240
Phone (210) 229-9085

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1356364384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8111 MAINLAND DR",
            "address_2": "SUITE 104448",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403748",
            "telephone_number": "210-363-5471",
            "fax_number": "888-471-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 HUEBNER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401803",
            "telephone_number": "210-541-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "MIKAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2023-03-07",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "L5386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164124306",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "8S7470",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TMHP",
            "identifier": "175829401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS #",
            "identifier": "551369",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE LICENSE #",
            "identifier": "L5386",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PROVIDER ID",
            "identifier": "202949040",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8DJ721",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.