Emilie Sue Jacobsen, MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

140163 Issued in MT

Practice address

400 13TH Ave S Ste 206
Great Falls, MT 59405-4300

Phone

(406) 731-8888

NPI assigned

Mar 19, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

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

Specialty

Micrographic Dermatologic Surgery (MDS)Also: Dermatology

Education

University of Washington School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Benefis Hospitals IncGroup PAC ID 1153235296, 390 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Benefis Hospitals Inc Hospital, Great Falls, MT, CCN 270012

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Benefis Hospitals Inc

  dba Benefis Medical Group

  • Multi-Specialty Clinic/Center
  • Great Falls, MT
  • NPI 1780968974
  Medicare reassignment Care Compare group NPD
• Benefis Hospitals, Inc.

  dba Benefis Senior Services

  • Physical Therapist
  • Great Falls, MT
  • NPI 1750530515
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Benefis Hospitals Inc

  dba Benefis Medical Group

  • Multi-Specialty Clinic/Center
  • Great Falls, MT
  • NPI 1780968974

  Hospital

  Care Compare affiliation
• Benefis Hospitals, Inc.

  • Air Ambulance
  • Great Falls, MT
  • NPI 1114934023

  Hospital

  Care Compare affiliation
• Benefis Hospitals, Inc.

  • General Acute Care Hospital
  • Great Falls, MT
  • NPI 1881650737
  Care Compare affiliation

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1548729445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6010",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594066010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 13TH AVE S STE 206",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054300",
            "telephone_number": "406-731-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 N 29th St",
            "address_purpose": "LOCATION",
            "city": "Billings",
            "state": "MT",
            "postal_code": "591010905",
            "country_code": "US",
            "telephone_number": "406-435-2210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8925 N Meridian St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462602385",
            "country_code": "US",
            "telephone_number": "317-660-4900",
            "fax_number": "317-660-4901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 W 86th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601902",
            "country_code": "US",
            "telephone_number": "317-338-2281",
            "fax_number": "317-338-2851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 10th Ave N",
            "address_purpose": "LOCATION",
            "city": "Billings",
            "state": "MT",
            "postal_code": "591010703",
            "country_code": "US",
            "telephone_number": "406-435-2210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8414 Naab Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601972",
            "country_code": "US",
            "telephone_number": "317-338-7510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "EMILIE",
        "middle_name": "SUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MT",
            "license": "140163",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01090118A",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MT",
            "license": "140163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheldon G. Ivers, DDS
• Jamey Lynn Ivey, LCPC
• Ivy at Great Falls LLC
• J Flair Wellness (Great Falls Health & Wellness)
• Luke Jarvis Jackson, CRNA
• Leah M Jacobsen, AU.D., CCC-A
• Daniel Wade Jacobson, RPH
• Venkatesh Jairam, MD
• Jamal Balouch, DO PC
• Amy Jo Jamieson

• MOHS-Micrographic Surgery Physician in Great Falls, MT
• Providers in Great Falls, MT by specialty
• MOHS-Micrographic Surgery Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; 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.