Individual provider Active NPI

Leonard Jacobson, M.D.

  • Ophthalmology Physician
  • Cincinnati, OH
National Provider Identifier
1679598262
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35030761 Issued in OH
Practice address
5240 E Galbraith Rd
Suite B
Cincinnati, OH 45236-2877
Phone
(513) 745-9787
Fax
(513) 745-9789
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35030761 OH Primary

Addresses

Primary practice location

5240 E Galbraith Rd
Suite B
Cincinnati, OH 45236-2877

Mailing address

5535 Fair LN
Suite C
Cincinnati, OH 45227-3434
Phone (513) 221-5274

Other identifiers 1

IdentifierTypeStateIssuer
0133993MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35030761OHMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1679598262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 FAIR LN",
            "address_2": "SUITE C",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452273434",
            "telephone_number": "513-221-5274",
            "fax_number": "513-961-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5240 E GALBRAITH RD",
            "address_2": "SUITE B",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452362877",
            "telephone_number": "513-745-9787",
            "fax_number": "513-745-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "LEONARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35030761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133993",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.