Dean S Jacobs, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A91057 Issued in CA

Practice address

1212 W 17TH St
Santa Ana, CA 92706-3418

Phone

(714) 954-0432

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: djacobs461872@direct.memorialcare.org

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.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350

  Pediatrics

  Medicare reassignment NPD
• Bristol Park Medical Group, Inc

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1043266760

  Pediatrics

  NPD (past)
• Children's Hospital of Orange County

  dba Rady Children's Hospital Orange County

  • Children's Hospital
  • Orange, CA
  • NPI 1811080526
  NPD (past)
• Eden Medical Center/San Leandro Hospital Campus

  dba San Leandro Hospital

  • Rehabilitation Hospital Unit
  • San Leandro, CA
  • NPI 1679523633
  NPD (past)
• Saddleback Memorial Medical Center

  • Rehabilitation Hospital Unit
  • Laguna Hills, CA
  • NPI 1114967114
  NPD (past)
• University of California Irvine

  dba Uci Health

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503964800000",
    "number": "1497802318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 W 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 W 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063418",
            "telephone_number": "714-954-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "DEAN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2017-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A91057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "A91057",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dejaeyon Jackson
• Jessica Parker Jackson
• Maryam Jackson VIII
• Kimberly Ann Jacobo
• Sarah Jacobo
• Evan Jacobs, RBT
• Troy Anthony Jacobs, MD, MPH, FAAP
• Cathleen Carmel Jacobson, LMFT
• Ilyana Jacobson, LCSW
• Pamela Jean Jacobson, LAC

• Pediatrics Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.