NPIMap

Individual provider Active NPI

Robyn Diane Jacoby, DO

  • Family Medicine Physician
  • Claremont, CA
National Provider Identifier
1487623575
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A7474 Issued in CA
Practice address
430 W Baseline Rd
Claremont, CA 91711-1696
Phone
(909) 621-3916
Fax
(909) 625-0903
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A7474 CA Primary

Addresses

Primary practice location

430 W Baseline Rd
Claremont, CA 91711-1696

Mailing address

840 Towne Center Dr
Pomona, CA 91767-5900
Phone (909) 398-1550

Other identifiers 1

IdentifierTypeStateIssuer
00AX74740MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050418001220 CA Practitioner - Family Practice 4385682681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chaparral Medical Group IncGroup PAC ID 6800709403, 66 clinicians

Practice addresses (Care Compare)

1866 N Orange Grove Ave
Pomona, CA 91767-3042

430 W Baseline Rd
Claremont, CA 91711-1607
Phone (909) 621-3916

Hospital & facility affiliations

  • A and E Home Health Services, Inc Home health agency, Upland, CA, CCN 058469
  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231
  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099
  • Casa Colina Hospital Hospital, Pomona, CA, CCN 050782

Merit-based Incentive Payment System (MIPS)

Final score
78.08 of 100Reported as group
Quality
40.87
Promoting interoperability
75
Improvement activities
40
Cost
74.84

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A7474CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chaparral Medical Group, Inc. CurrentSince Sep 24, 2001 Accepting new patients
Chaparral Medical Group Inc. CurrentSince Sep 24, 2001 Accepting new patients
Chaparral Medical Group, Inc. Current Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Chaparral Medical Group Inc Past Accepting new patients
Chino Medical Group, Inc Family Medicine Past Accepting new patients

Locations

430 W Baseline Rd
Claremont, CA 91711
Phone (909) 621-3916

1801 W Olympic Blvd
Pasadena, CA 91199

1904 N Orange Grove Ave
Pomona, CA 91767
Phone (909) 469-1823

1866 N Orange Grove Ave
Ste 202
Pomona, CA 91767
Phone (909) 623-8796

840 Towne Center Dr
Pomona, CA 91767

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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 5

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1487623575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1550",
            "fax_number": "909-398-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W BASELINE RD",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917111696",
            "telephone_number": "909-621-3916",
            "fax_number": "909-625-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "ROBYN",
        "middle_name": "DIANE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX74740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

Verify at the official NPI Registry.