Individual provider Active NPI

Elena J Jacobson, PA-C

  • Physician Assistant
  • Columbia, SC
National Provider Identifier
1487957668
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5546 Issued in SC
Practice address
3 Richland Medical Park Dr Ste 310
Columbia, SC 29203-6862
Phone
(803) 434-8323
Fax
(803) 434-8326
NPI assigned
Dec 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110003408 VA
Physician Assistant 363A00000X 4121 MA
Physician Assistant 363A00000X 5546 SC Primary

Addresses

Primary practice location

3 Richland Medical Park Dr Ste 310
Columbia, SC 29203-6862

Mailing address

300 E McBee Ave Ste 300
Greenville, SC 29601-2899
Phone (864) 522-8611

Other practice location 1

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-2325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, SC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20140715001528 DC Practitioner - Physician Assistant 1557543295 Reassigns benefits to 2 organizations
I20201028001470 VA Practitioner - Physician Assistant 1557543295 Reassigns benefits to 2 organizations
I20250321000703 SC Practitioner - Physician Assistant 1557543295

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, shared by 24 NPIs, 1,821 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307

3800 Fettler Park Dr
Suite 312
Dumfries, VA 22025-2043
Phone (571) 472-6791

44045 Rivderside Pkwy
Leesburg, VA 20176-5101

8081 Innovation Park Dr
Fairfax, VA 22031-4867

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063
  • Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043
  • Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101
  • Sentara Northern Virginia Medical Center Hospital, Woodbridge, VA, CCN 490113

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4121MAMDPhysician Assistant
5546SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jun 16, 2014 Accepting new patients
Inova Health Care Services CurrentSince Jun 16, 2014 Accepting new patients
Inova Health Care Services CurrentSince Sep 4, 2024 Accepting new patients
Inova Health Care Services CurrentSince Jul 6, 2024 Accepting new patients
Prisma Health Medical Group-Midlands Past Accepting new patients

Locations

3800 Fettler Park Dr
Ste 312
Dumfries, VA 22025
Phone (571) 472-6791

8095 Innovation Park Dr
Bldg C
Fairfax, VA 22031
Phone (571) 472-6253

8081 Innovation Park Dr
Ste 900
Fairfax, VA 22031
Phone (571) 472-4200

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Interoperability endpoints

  • Direct secure messaging: ejacobson15056@soc.inova.org

Organizations & group practices 5

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 6

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": "1291939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1487957668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012899",
            "telephone_number": "864-522-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RICHLAND MEDICAL PARK DR STE 310",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036862",
            "telephone_number": "803-434-8323",
            "fax_number": "803-434-8326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "703-776-2325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ELENA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-10",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003408",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "4121",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.