Lisa Marie Cantor-Jacobson, M.D.
Individual provider Active NPI Psychiatry Physician · Batavia, OH
NPI 1649255167 · NPPES record last updated Jun 2, 2022
Key facts
- NPI
- 1649255167
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 35.070977 (OH)
- Practice address
- 3000 Hospital Dr
Batavia, OH 45103-1921 - Phone
- (513) 732-8629
- Fax
- (513) 732-8626
- NPI assigned
- Dec 7, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.070977 | OH | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychiatric Professional Services | Psychiatry | Past | Accepting new patients |
| West Chester Hospital LLC | Family Medicine | Past | Accepting new patients |
| University Family Physicians, Inc. | Family Medicine | Past | Accepting new patients |
| University of Cincinnati Medical Center, LLC | Past | Accepting new patients |
Interoperability endpoints
- lcantorjacobson1006185@direct.bsmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 35.070977 | OH | Yes |
| Family Medicine Physician | 207Q00000X | 35.070977 | OH |
Addresses
Primary practice location
3000 Hospital Dr
Batavia, OH 45103-1921
Mailing address
3000 Hospital Dr
Batavia, OH 45103-1921
Phone (513) 732-8629
Other practice location 1
2222 Philadelphia Dr
Ste. 4505
Dayton, OH 45406-1813
Phone (937) 499-8273
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2183971 | Medicaid | OH |
Other names
- Lisa Marie Cantor
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| RESTful URL | lcantorjacobson846279@direct.premierhealth.com |
Other providers in Batavia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.