Theresa A Jacobsen, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP2138 Issued in AZ

Practice address

2304 E Geneva Dr
Tempe, AZ 85282-4147

Phone

(480) 878-5306

NPI assigned

Aug 24, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Atlas Medical Aco LLCGroup PAC ID 1456885227, 50 clinicians

Century Care IncGroup PAC ID 3971665605, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aegis Homecare, Inc Home health agency, Mesa, AZ, CCN 037422
• Aegis Hospice, Inc. Hospice, Mesa, AZ, CCN 031613

Merit-based Incentive Payment System (MIPS)

Final score

77.24 of 100Reported as group

Quality

66.21

Improvement activities

40

Cost

66.73

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: theresa.jacobsen@57560418353156.direct.elationemr.com

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.

• Atlas Medical Aco LLC

  • Clinic/Center
  • Mesa, AZ
  • NPI 1396573705
  Medicare reassignment Care Compare group NPD
• Century Care Inc

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1346499324
  Medicare reassignment Care Compare group NPD
• Ernesto R Cruz MD PC

  • Cardiovascular Disease Physician
  • Scottsdale, AZ
  • NPI 1144410374
  NPD (past)
• Integrative Cardiology PLLC

  • Cardiovascular Disease Physician
  • Scottsdale, AZ
  • NPI 1649262064
  NPD (past)

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

• Aegis Homecare, Inc

  • Home Health Agency
  • Mesa, AZ
  • NPI 1902179302
  Care Compare affiliation
• Aegis Hospice, Inc

  • Community Based Hospice Care Agency
  • Mesa, AZ
  • NPI 1356614754
  Care Compare affiliation

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500854400000",
    "number": "1689667883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 E GERMANN RD",
            "address_2": "STE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85286",
            "telephone_number": "480-878-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 E GENEVA DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852824147",
            "telephone_number": "480-878-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2017-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "RN063885",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP2138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "938798-03",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2Z9842",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamara L Jackson, LMSW
• Zipporah Hezekiah Jackson
• Carly Jacobs, MT-BC
• Daniel Aaron Jacobs, M.D.
• Jasmyn Jache Jacobs, RBT
• Jadem Ark of Hope, LLC
• Emmanuel Jagdon
• Fatou Jagne
• David J Jagoda, M.D.
• Vanya Jaitly, MD

• Nurse Practitioner in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2017; 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.