Active NPI
Sandhya Jacob, MD
- Diagnostic Radiology Physician
- Tacoma, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD60949842
- Practice address
- 1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900 - Phone
- (253) 761-4200
- Fax
- (253) 761-4201
- NPI assigned
- Apr 1, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD60949842 | WA | Primary |
Addresses
Primary practice location
1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Mailing address
PO Box 1535
Tacoma, WA 98401-1535
Phone (253) 761-4200
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0422789 | Other | WA | L&I-TRA-KING |
| 0422792 | Other | WA | L&I-DIAGNOSTIC IMAGING NW |
| 2133414 | Medicaid | WA | |
| 0422785 | Other | WA | L&I-TRA-REST OF WA |
| 0422790 | Other | WA | L&I-UNION AVENUE OPEN MRI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2502 S Union Ave
Tacoma, WA 98405-1328
Phone (253) 841-4353
423 NE Maple Leaf PL
Seattle, WA 98115-5317
Phone (253) 841-4353
Hospital & facility affiliations
- Tacoma General Allenmore Hospital
- St Joseph Medical Center
- St Anthony Hospital
- St Francis Community Hospital
- Multicare Good Samaritan Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60949842 | WA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance | Current | Accepting new patients | |
| Proliance Surgeons Inc P S | Current | Accepting new patients | |
| Proliance Surgeons Inc P S | Current | Accepting new patients | |
| Tra Medical Imaging Centers LLC | Current | Accepting new patients | |
| Proliance Surgeons, Inc., P.S. | Diagnostic Radiology | Current | Accepting new patients |
| Union Avenue Open MRI LLC | Current | Accepting new patients |
Locations
510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030
222 15th Ave SE
Puyallup, WA 98372
1101 Madison St
Ste 580
Seattle, WA 98104
Phone (206) 400-7625
805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100
2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900
1304 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 680-3372
3402 S 18th St
Tacoma, WA 98405
Phone (253) 383-1099
9601 Steilacoom Blvd SW
Tacoma, WA 98498
Phone (253) 582-8900
Interoperability endpoints
- https://app.meldrx.com/api/fhir/ei-trami
- sandhya.jacobs.p42@direct.proliance.nextgenshare.com
Organizations & group practices 7
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.
-
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1083802946
-
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1568531242
-
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1396814166
-
- Orthopaedic Surgery Physician
- Seattle, WA
- NPI 1023170313
-
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1447041751
-
- Orthopaedic Surgery Physician
- Renton, WA
- NPI 1235091463
-
- Diagnostic Ultrasound Physician
- Seattle, WA
- NPI 1790325710
Diagnostic Radiology
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1124291117
-
- General Acute Care Hospital
- Gig Harbor, WA
- NPI 1447406699
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1952309098
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1366556227
-
- General Acute Care Hospital
- Puyallup, WA
- NPI 1841231461
-
- General Acute Care Hospital
- Federal Way, WA
- NPI 1093713091
-
- General Acute Care Hospital
- Federal Way, WA
- NPI 1922305606
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593561600000",
"number": "1619395100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1535",
"city": "TACOMA",
"state": "WA",
"postal_code": "984011535",
"telephone_number": "253-761-4200",
"fax_number": "253-383-3553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 FAWCETT AVE STE 100",
"city": "TACOMA",
"state": "WA",
"postal_code": "984021900",
"telephone_number": "253-761-4200",
"fax_number": "253-761-4201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "SANDHYA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-01",
"last_updated": "2020-07-01",
"certification_date": "2020-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WA",
"license": "MD60949842",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-TRA-KING",
"identifier": "0422789",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-DIAGNOSTIC IMAGING NW",
"identifier": "0422792",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2133414",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-TRA-REST OF WA",
"identifier": "0422785",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-UNION AVENUE OPEN MRI",
"identifier": "0422790",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.