Irina Iacobucci, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD179390 Issued in OR

Practice address

2865 Daggett Ave
Klamath Falls, OR 97601-1106

Phone

(541) 882-6311

NPI assigned

Mar 24, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Family Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bristol Hospice - Klamath Falls Hospice, Klamath Falls, OR, CCN 381551
• Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Medicare reassignment Care Compare group NPD
• Sky Lakes Medical Center Inc

  dba Sky Lakes Specialty Pharmacy

  • Community/Retail Pharmacy
  • Klamath Falls, OR
  • NPI 1003654625
  NPD

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

• High Desert Hospice LLC

  dba Bristol Hospice - Klamath Falls

  • Community Based Hospice Care Agency
  • Klamath Falls, OR
  • NPI 1033191440
  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • Occupational Therapist
  • Klamath Falls, OR
  • NPI 1134270911

  Hospital

  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Care Compare affiliation

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679990048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-882-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-882-6311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 Daggett Ave",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976017150",
            "country_code": "US",
            "telephone_number": "503-494-8211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2801 Daggett Ave",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976017150",
            "country_code": "US",
            "telephone_number": "503-494-8211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IACOBUCCI",
        "first_name": "IRINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD179390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Leigh Hunter, LPN
• Jessica Lynn Hurd
• Molly Cate Hurd, MD
• Amy Hutchinson, RD
• Alexandria Shannon Hutzell, O.D.
• Garrison Iams
• Icco, LLC (BestMed)
• Anthony Jonathan Idrogo
• Elizabeth Ann Idrogo, B.S.
• Sidra Iftikhar, MD

• Family Medicine Physician in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.

Verify at the official NPI Registry.