Individual provider Active NPI

Scott Jacobsen, DPM

  • Foot & Ankle Surgery Podiatrist
  • Libertyville, IL
National Provider Identifier
1386674950
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016-005031 Issued in IL
Practice address
720 Florsheim Dr
Libertyville, IL 60048-3757
Phone
(847) 247-4000
Fax
(847) 234-2090
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016-005031 IL Primary

Addresses

Primary practice location

720 Florsheim Dr
Libertyville, IL 60048-3757

Mailing address

900 Rand Rd
Suite 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040225000237 IL Practitioner - Podiatry 6406742600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Bone and Joint Institute, LLCGroup PAC ID 6002814878, 603 clinicians

Practice addresses (Care Compare)

1025 Red Oak LN
Suite 100
Lindenhurst, IL 60046-5017
Phone (847) 336-3335

Hospital & facility affiliations

  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016-005031ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute LLC CurrentSince Oct 7, 2013 Accepting new patients
Illinois Bone and Joint Institute, LLC CurrentSince Oct 7, 2013 Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

1275 E Belvidere Rd
Ste 150
Grayslake, IL 60030
Phone (847) 735-0828

350 S Greenleaf St
Ste 405
Gurnee, IL 60031
Phone (847) 336-3335

101 Waukegan Rd
Ste 1100
Lake Bluff, IL 60044
Phone (847) 247-2402

101 Waukegan Rd
Ste 990
Lake Bluff, IL 60044
Phone (847) 336-3335

720 Florsheim Dr
Libertyville, IL 60048
Phone (847) 247-4000

716 Florsheim Dr
Libertyville, IL 60048
Phone (847) 918-9077

1025 Red Oak Ln
Ste 100
Lindenhurst, IL 60046
Phone (847) 245-7175

Organizations & group practices 2

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 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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1386674950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD",
            "address_2": "SUITE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 FLORSHEIM DR",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483757",
            "telephone_number": "847-247-4000",
            "fax_number": "847-234-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "SCOTT",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016-005031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.