Lisa Jacobs, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R038704 Issued in ME

Practice address

268 Stillwater Ave
Bangor, ME 04401-3945

Phone

(207) 973-7306

Fax

(207) 973-6109

NPI assigned

Sep 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

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 1

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastport Health Care, IncGroup PAC ID 3577592880, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Calais Community Hospital Hospital, Calais, ME, CCN 201305

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
• Direct secure messaging: lisa.jacobs.1@8309.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/8309/brand/1/csg/1/fhir/r4

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.

• Eastport Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Eastport, ME
  • NPI 1093752917
  Medicare reassignment Care Compare group NPD
• Bridgton Hospital

  • Critical Access Hospital
  • Bridgton, ME
  • NPI 1154370153
  Medicare reassignment NPD
• Central Maine Medical Center

  • General Acute Care Hospital
  • Lewiston, ME
  • NPI 1689653487
  Medicare reassignment NPD
• Rumford Hospital

  • Critical Access Hospital
  • Rumford, ME
  • NPI 1205991122
  Medicare reassignment NPD
• The Blue Hill Memorial Hospital

  • Critical Access Hospital
  • Blue Hill, ME
  • NPI 1023057809
  Medicare reassignment NPD
• Acadia Hospital Corp

  • Psychiatric Hospital
  • Bangor, ME
  • NPI 1215940523
  Medicare reassignment
• Acadia Healthcare, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bangor, ME
  • NPI 1568477297
  NPD
• Bridgton Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Bridgton, ME
  • NPI 1477691467
  NPD
• Central Maine Medical Center

  • Community/Retail Pharmacy
  • Lewiston, ME
  • NPI 1033874458
  NPD
• Eastport Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Machias, ME
  • NPI 1295020691
  NPD
• Rumford Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Rumford, ME
  • NPI 1982742482
  NPD
• The Blue Hill Memorial Hospital

  • Critical Access Hospital
  • Blue Hill, ME
  • NPI 1023272853
  NPD

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

• Calais Community Hospital

  • Critical Access Hospital
  • Calais, ME
  • NPI 1922001049
  Care Compare affiliation

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441324800000",
    "number": "1568554186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21823 E SANDY HILL LN",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466289518",
            "telephone_number": "574-807-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013945",
            "telephone_number": "207-973-7306",
            "fax_number": "207-973-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "LISA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2015-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "R038704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah C Isaacson, LMSW-CC
• Lori S Isenhower, DO
• Sally W Ives, LPE
• Abimbola Mary Iwegbulam, NP
• Lauri Jacobs, RD,CDE
• Emilie Ann Irene Jacobsen, ADCA
• Meghan L Jacques, PAC
• Rosanne Sarita Jagger, MD
• John R. Jaksa, LCSW
• Maynard L Jalbert, LCPC

• Psychiatric/Mental Health Nurse Practitioner in Bangor, ME
• Providers in Bangor, ME by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; 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.