Active NPI
Michael Todd Jacobs, M.D.
- Diagnostic Radiology Physician
- Hickory, NC
National Provider Identifier
1659482040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 200100384
- Practice address
- 18 13TH Ave NE
Hickory, NC 28601-3748 - Phone
- (828) 322-2644
- Fax
- (828) 327-2235
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | 200100384 | NC | |
| Neuroradiology Physician | 2085N0700X | 200100384 | NC | |
| Nuclear Radiology Physician | 2085N0904X | 200100384 | NC | |
| Pediatric Radiology Physician | 2085P0229X | 200100384 | NC | |
| Diagnostic Radiology Physician | 2085R0202X | 200100384 | NC | Primary |
| Therapeutic Radiology Physician | 2085R0203X | 200100384 | NC | |
| Vascular & Interventional Radiology Physician | 2085R0204X | 200100384 | NC | |
| Radiological Physics Physician | 2085R0205X | 200100384 | NC | |
| Diagnostic Ultrasound Physician | 2085U0001X | 200100384 | NC |
Addresses
Primary practice location
18 13TH Ave NE
Hickory, NC 28601-3748
Mailing address
PO Box 308
Hickory, NC 28603-0308
Phone (828) 322-2644
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 129G7 | Other | NC | BCBS |
| 560941927 | Other | NC | MEDCOST |
| 300132080 | Other | NC | RAILROAD MEDICARE |
| 89129G7 | Medicaid | NC | |
| 560941927 | Other | NC | UNITED HEALTHCARE |
| 246190 | Other | NC | MAMSI |
| 560941927 | Other | NC | CIGNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- 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 CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200100384 | NC | MD | Diagnostic Ultrasound Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catawba Radiological Associates, Inc. | Body Imaging | Current | Accepting new patients |
Locations
18 13th Ave NE
Hickory, NC 28601
Phone (828) 322-2644
Interoperability endpoints
- tjacobs107825@direct.unc.nchie.net
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Hickory, NC
- NPI 1679684948
Body Imaging
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330473600000",
"number": "1659482040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 308",
"city": "HICKORY",
"state": "NC",
"postal_code": "286030308",
"telephone_number": "828-322-2644",
"fax_number": "828-327-2235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 13TH AVE NE",
"city": "HICKORY",
"state": "NC",
"postal_code": "286013748",
"telephone_number": "828-322-2644",
"fax_number": "828-327-2235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "MICHAEL",
"middle_name": "TODD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2012-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "NC",
"license": "200100384",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "NC",
"license": "200100384",
"primary": false
},
{
"code": "2085N0904X",
"taxonomy_group": "",
"desc": "Radiology, Nuclear Radiology",
"state": "NC",
"license": "200100384",
"primary": false
},
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "NC",
"license": "200100384",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NC",
"license": "200100384",
"primary": true
},
{
"code": "2085R0203X",
"taxonomy_group": "",
"desc": "Radiology, Therapeutic Radiology",
"state": "NC",
"license": "200100384",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "NC",
"license": "200100384",
"primary": false
},
{
"code": "2085R0205X",
"taxonomy_group": "",
"desc": "Radiology, Radiological Physics",
"state": "NC",
"license": "200100384",
"primary": false
},
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "NC",
"license": "200100384",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "129G7",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "560941927",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300132080",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89129G7",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "560941927",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "246190",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "560941927",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hickory, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.