Immanuel Jacquez, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A184944 Issued in CA

Practice address

1959 NE Pacific St Box 356410
Seattle, WA 98195-6140

Phone

(559) 901-1335

NPI assigned

Apr 11, 2016

Last updated

Jul 3, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Anesthesiology

Education

Indiana University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Consultants of California Medical Group IncGroup PAC ID 3375456692, 37 clinicians

Palomar Anesthesia Partners IncGroup PAC ID 3577046044, 39 clinicians

Oak Creek Anesthesia Services IncGroup PAC ID 9739509407, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Palomar Health Downtown Campus Hospital, Escondido, CA, CCN 050115
• Kaweah Health Medical Center Hospital, Visalia, CA, CCN 050057
• Palomar Medical Center Poway Hospital, Poway, CA, CCN 050636

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anesthesia Consultants of California Medical Group Inc

  • Anesthesiology Physician
  • Escondido, CA
  • NPI 1164463055
  Medicare reassignment Care Compare group NPD
• Oak Creek Anesthesia Services, Inc.

  • Anesthesiology Physician
  • Visalia, CA
  • NPI 1619589512
  Medicare reassignment Care Compare group NPD
• Palomar Anesthesia Partners Inc

  • Anesthesiology Physician
  • Escondido, CA
  • NPI 1174490445
  Medicare reassignment Care Compare group NPD

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

• Kaweah Delta Health Care District

  dba Kaweah Health Medical Center

  • General Acute Care Hospital
  • Visalia, CA
  • NPI 1588663769
  Care Compare affiliation
• Palomar Health

  dba Palomar Medical Center Poway

  • General Acute Care Hospital
  • Poway, CA
  • NPI 1376513754
  Care Compare affiliation
• Palomar Health

  dba Palomar Medical Center Escondido

  • General Acute Care Hospital
  • Escondido, CA
  • NPI 1457321317
  Care Compare affiliation

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1366806879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 W MICHIGAN ST # FH204",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025209",
            "telephone_number": "559-901-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST BOX 356410",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956140",
            "telephone_number": "559-901-1335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1130 W Michigan St # Fh204",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025209",
            "country_code": "US",
            "telephone_number": "559-901-1335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACQUEZ",
        "first_name": "IMMANUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A184944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael John Jacobus, LMP, CTP
• Mark Warner Jacokes, M.D.
• Katherine Marie Jacolev, MA CFY SLP
• Jacqueline Tiffin DDS PLLC
• Kathleen Elizabeth Jacques, D.D.S.
• Jacquie Gallaway, LLC
• Jennifer Jacyszyn, MA
• Jad3 P.S. (Lifestyle Chiropractic)
• Jada Health Corporation
• Jade Kim DDS PS

• Anesthesiology Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Anesthesiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.