Individual provider Active NPI

Jacob Joseph Becker, M.D.

  • Diagnostic Radiology Physician
  • Columbia, MO
National Provider Identifier
1679852271
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD2016-0110 Issued in NM
Practice address
1 Hospital Dr # Dc018.00
Columbia, MO 65201-5276
Phone
(573) 884-5697
Fax
(573) 884-8876
NPI assigned
Aug 12, 2011
Last updated
Jun 24, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2011019836 MO
Diagnostic Radiology Physician 2085R0202X MD2016-0110 NM Primary
Diagnostic Radiology Physician 2085R0202X DR.0056443 CO

Addresses

Primary practice location

1 Hospital Dr # Dc018.00
Columbia, MO 65201-5276

Mailing address

1 Hospital Dr # Dc018.00
Columbia, MO 65201-5276
Phone (573) 884-5697

Other identifiers 1

IdentifierTypeStateIssuer
2011019836OtherMOMISSOURI STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20170901000539 CO Practitioner - Diagnostic Radiology 0244522266 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Missouri, Columbia School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10275 Tradition PL
Lone Tree, CO 80124-8505
Phone (216) 444-2200

1580 Red Hawk CT
Steamboat Springs, CO 80487-2320
Phone (573) 619-8487

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0056443COMDDiagnostic Radiology Physician
2011019836MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uchealth Imaging Services, LLC Diagnostic Radiology CurrentSince Dec 14, 2020 Accepting new patients
Uchealth Imaging Services, LLC Diagnostic Radiology Current Accepting new patients
Radiology & Imaging Consultants PC Diagnostic Radiology CurrentSince Jul 29, 2017 Accepting new patients
Cleveland Clinic Health Services Professional Association, Inc CurrentSince Jul 27, 2022 Accepting new patients
Uchealth Imaging Services, LLC CurrentSince Dec 14, 2020 Accepting new patients

Locations

106 Blanca Ave
Alamosa, CO 81101
Phone (719) 589-2511

875 W 136th Ave
Ste 100
Broomfield, CO 80023
Phone (303) 457-7700

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

175 S Union Blvd
Colorado Springs, CO 80910
Phone (719) 305-8000

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1679852271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR # DC018.00",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015276",
            "telephone_number": "573-884-5697",
            "fax_number": "573-884-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR # DC018.00",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015276",
            "telephone_number": "573-884-5697",
            "fax_number": "573-884-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "JACOB",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-12",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2011019836",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "MD2016-0110",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0056443",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI STATE LICENSE",
            "identifier": "2011019836",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.