NPIMap

Individual provider Active NPI

Lee S. Jacobson, M.D., PH.D.

  • Emergency Medicine Physician
  • Boston, MA
National Provider Identifier
1508204777
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
255696 Issued in MA
Practice address
1 Deaconess Rd
Dept. of Emergency Medicine, W-CC2
Boston, MA 02215-5321
Phone
(617) 754-2323
Fax
(617) 754-2350
NPI assigned
Jun 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 255696 MA Primary

Addresses

Primary practice location

1 Deaconess Rd
Dept. of Emergency Medicine, W-CC2
Boston, MA 02215-5321

Mailing address

1 Deaconess Rd
Dept. of Emergency Medicine, W-CC2
Boston, MA 02215-5321
Phone (617) 754-2323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20161208002228 NY Practitioner - Emergency Medicine 3779863774 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Emergency Physicians PLLCGroup PAC ID 8820225956, 31 clinicians
St Francis HospitalGroup PAC ID 9234101221, 96 clinicians
Mercy Medical CenterGroup PAC ID 4082518006, 83 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 562-6000

1000 N Village Ave
Rockville Center, NY 11570-1000
Phone (516) 705-3428

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.12 of 100Reported as group
Quality
88.22
Promoting interoperability
100
Improvement activities
40
Cost
73.09

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
255696MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Medical CurrentSince Apr 1, 2019 Accepting new patients
St. Francis Hospital Current Accepting new patients
Mercy Medical Center CurrentSince Oct 1, 2023 Accepting new patients
Progressive Emergency Physicians PLLC Emergency Medicine CurrentSince Mar 19, 2019 Accepting new patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Oct 29, 2016 Accepting new patients
St. Francis Hospital CurrentSince Mar 19, 2019 Accepting new patients
Good Samaritan Hospital Medical Center Current Accepting new patients
Samaritan Emergency Medical Services, PC Emergency Medicine CurrentSince Apr 28, 2019 Accepting new patients
St Francis Hospital United States Catholic Conference CurrentSince Mar 19, 2019 Accepting new patients
Mercy Medical Center Current Accepting new patients

Locations

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 10

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 4

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": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1508204777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DEACONESS RD",
            "address_2": "DEPT. OF EMERGENCY MEDICINE, W-CC2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155321",
            "telephone_number": "617-754-2323",
            "fax_number": "617-754-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DEACONESS RD",
            "address_2": "DEPT. OF EMERGENCY MEDICINE, W-CC2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155321",
            "telephone_number": "617-754-2323",
            "fax_number": "617-754-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "LEE",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "255696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.