Jacob Michael Poulsen, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

81900 Issued in AZ

Practice address

1842 E Elm
Tucson, AZ 85724-0001

Phone

(520) 626-7233

NPI assigned

Jul 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in UT, CO2 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 2

Specialty

Emergency Medicine

Education

Washington University School of Medicine, 2007

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain View Hospital Hospital, Payson, UT, CCN 460013
• Delta County Memorial Hospital Hospital, Delta, CO, CCN 060071

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Delta County Memorial Hospital

  • Rural Acute Care Hospital
  • Delta, CO
  • NPI 1417935446
  Medicare reassignment
• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199
  Medicare reassignment
• Stronghold Emergency Physicians

  • Emergency Medicine Physician
  • Willcox, AZ
  • NPI 1306895909
  NPD (past)
• Associates for Inpatient Medicine, LLC

  • Internal Medicine Physician
  • Salt Lake City, UT
  • NPI 1750488433
  NPD (past)
• Emergency Medical Billing LLC

  • Personal Emergency Response Attendant
  • Payson, UT
  • NPI 1487792255
  NPD (past)

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

• Delta County Memorial Hospital

  • Rural Acute Care Hospital
  • Delta, CO
  • NPI 1417935446
  Care Compare affiliation
• Mountain View Hospital, Inc.

  • General Acute Care Hospital
  • Payson, UT
  • NPI 1487607669
  Care Compare affiliation

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1467642447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8206 N WHEATFIELD DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857411258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1842 E ELM",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857240001",
            "telephone_number": "520-626-7233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Delta",
            "state": "CO",
            "postal_code": "814162815",
            "country_code": "US",
            "telephone_number": "970-874-7681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POULSEN",
        "first_name": "JACOB",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "81900",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0076354",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA MEDICAL BOARD",
            "identifier": "81900",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000255490",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Yoopapun Potter, MD
• Sarah Potter, PHARM D
• Brenda B Pottinger, HIS
• Danielle Renea Poulin, OTRL
• Veronique Poulin, M.D
• Pound of Cure LLC
• Kevin L Pounds, MD
• Tarannom Pourjafar
• Alireza Pourjavid
• Tania Pourshams-Manzouri, PHARMD

• Emergency Medicine Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.