Edwin Lawrence Jacobs, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

G62813 Issued in CA

Practice address

181 S Buena Vista St
4RTH Floor
Burbank, CA 91505-4504

Phone

(818) 840-0921

Fax

(818) 840-7064

NPI assigned

Jul 19, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in CA, TN, MS3 enrollments

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 3

Specialty

Hematology/Oncology

Education

University of California, Geffen School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The West Clinic P.C.Group PAC ID 2668360579, 115 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
• Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141
• Providence Saint Joseph Medical Ctr Hospital, Burbank, CA, CCN 050235
• Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• The West Clinic P.C.

  • Specialist
  • Germantown, TN
  • NPI 1447276605

  Hematology & Oncology, MS

  Medicare reassignment Care Compare group NPD
• East Valley Hematolgy and Oncology Medical Group Inc.

  • Hematology & Oncology Physician
  • Burbank, CA
  • NPI 1750307278
  NPD Authorized official
• East Valley Hematology Oncology Medical Group

  • Hematology & Oncology Physician
  • Burbank, CA
  • NPI 1477721868
  NPD Authorized official
• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1417915760
  Medicare reassignment
• Elliot M. Hirsch, M.D., Inc.

  • Plastic and Reconstructive Surgery Physician
  • Sherman Oaks, CA
  • NPI 1356755730
  NPD (past)
• Providence Health System - Southern California

  • General Acute Care Hospital
  • Burbank, CA
  • NPI 1336173269
  NPD (past)

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

• Providence Health System - Southern California

  • General Acute Care Hospital
  • Burbank, CA
  • NPI 1336173269
  Care Compare affiliation
• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172
  Care Compare affiliation
• Baptist Memorial Hospital-Desoto, Inc,

  • General Acute Care Hospital
  • Southaven, MS
  • NPI 1194789818
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450
  Care Compare affiliation

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1366462939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51194",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900515494",
            "telephone_number": "818-840-0921",
            "fax_number": "818-840-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 S BUENA VISTA ST",
            "address_2": "4RTH FLOOR",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054504",
            "telephone_number": "818-840-0921",
            "fax_number": "818-840-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "EDWIN",
        "middle_name": "LAWRENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G62813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOG628130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Jean Jackson, P.T.
• Dawn Jackson
• Jobe Jackson
• Yasmine Jackson
• Amaris Priscilla Jacobs
• Jacqueline a. Kuraishi, D.D.S.,Inc.
• Jade Health Ventures, Inc
• Jae Bum Lee DDS Inc
• Edward J Jahnke III, M.D.
• Manjula Jain, M.D.

• Hematology & Oncology Physician in Burbank, CA
• Providers in Burbank, CA by specialty
• Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; 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.