Michelle Evelyn Jacobson, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP018170 Issued in PA

Practice address

145 Hospital Ave Ste 205
Du Bois, PA 15801-1464

Phone

(814) 375-3910

NPI assigned

Nov 29, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

79.49 of 100Reported as group

Quality

67.97

Improvement activities

40

Cost

74.35

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjacobson@dna.medentdirect.com
• Direct secure messaging: mjacobson@drca.medentdirect.com

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.

• Dubois Regional Cardiology Associates LLC

  • Cardiovascular Disease Physician
  • Du Bois, PA
  • NPI 1477594232
  Medicare reassignment NPD
• Dubois Regional Medical Center

  dba Penn Highlands DuBois

  • General Acute Care Hospital
  • Du Bois, PA
  • NPI 1144249657
  NPD (past)

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514505600000",
    "number": "1467966473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1388 HIGHLAND PARK RD",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157679736",
            "telephone_number": "814-591-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HOSPITAL AVE STE 205",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011464",
            "telephone_number": "814-375-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "MICHELLE",
        "middle_name": "EVELYN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-29",
        "last_updated": "2017-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irad Professionals Inc
• Kaitlin Ireland, BA
• Dana R Irwin
• J. Rice Oral Maxillofacial and Aesthetic Facial Surgery P.C.
• Jenna Irene Jacobson, BCBA
• Jawahar Suvarnakar, MD Inc.
• Dawn Renee Jeannerat, NP
• Tabatha L. Jeffers
• John a. Fabre, MD PC
• John E. Dubois III D C (Life Expressions Chiropractic Center)

• Family Nurse Practitioner in Du Bois, PA
• Providers in Du Bois, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; 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.