Jeffrey Randall Jacobson, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

036.114116 Issued in IL

Practice address

909 South Wolcott Avenue
3141 Comrb
Chicago, IL 60612-3725

Phone

(312) 996-8039

Fax

(312) 996-4665

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine

Education

New York University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

Merit-based Incentive Payment System (MIPS)

Final score

93.28 of 100Reported as group

Quality

73.53

Promoting interoperability

100

Improvement activities

40

Cost

70.73

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjacobson17136@uihealth.direct-ci.com

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.

• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment Care Compare group NPD
• The Board of Trustees of the University of Illinois

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1942244645

  Critical Care Medicine

  NPD
• Board of Trustees of the University of Illinois

  • Pediatrics Physician
  • Peoria, IL
  • NPI 1467425322
  NPD (past)
• The Board of Trustees of the University of Illinois

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1861431751
  NPD (past)

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

• The Board of Trustees of the University of Illinois

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1861431751
  Care Compare affiliation

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1609937432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 SOUTH WOLCOTT AVENUE",
            "address_2": "3141 COMRB",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123725",
            "telephone_number": "312-996-8039",
            "fax_number": "312-996-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 SOUTH WOLCOTT AVENUE",
            "address_2": "3141 COMRB",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123725",
            "telephone_number": "312-996-8039",
            "fax_number": "312-996-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "JEFFREY",
        "middle_name": "RANDALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036114116",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036.114116",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036.114116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114116",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beatriz Vera Jacobson
• Claire L Jacobson
• Daniel Raymond Jacobson, M.D.
• Danielle Jacobson
• Hannah Jacobson
• Jenna Marie Jacobson, PA-C
• Karen Robson Jacobson, MA LCPC LMFT
• Melissa A Jacobson
• Phillip Albert Jacobson, M.D.
• Rebecca Wolf Jacobson, MSW, LCSW

• Pulmonary Disease Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pulmonary Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.