NPIMap

Individual provider Active NPI

Donald J Jacobs, MD

  • Family Medicine Physician
  • Iron Mountain, MI
National Provider Identifier
1699757286
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301022733 Issued in MI
Practice address
1711 S Stephenson Ave Ste 125
Iron Mountain, MI 49801-3649
Phone
(906) 776-5810
Fax
(906) 228-0218
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 1

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 1957
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dickinson County Healthcare System 103 clinicians

Practice addresses (Care Compare)

1711 S Stephenson Ave
210 MMC Dickinson Telemedicine
Iron Mountain, MI 49801-3649
Phone (906) 776-5800

Hospital & facility affiliations

  • Dickinson County Memorial Hospital Hospital, Iron Mountain, MI, CCN 230055
  • Marshfield Medical Center Hospital, Iron Mountain, MI, CCN 231342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050503001192 MI Practitioner - Family PracticePractitioner - General Surgery 8820038466 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dickinson County Healthcare System Family Medicine CurrentSince Oct 1, 1983 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients

Locations

1711 S Stephenson Ave
Ste 125
Iron Mountain, MI 49801
Phone (906) 776-5810

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

844 Pyle Dr
Kingsford, MI 49802
Phone (906) 774-1155

1010 Olive Ave
Florence, WI 54121
Phone (715) 528-4775

Interoperability endpoints

  • Direct secure messaging: donald.jacobs.1@22710.direct.athenahealth.com
  • Direct secure messaging: donald.jacobs@marshfieldclinichealthsystem.cernerdirect.com

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301022733 MI Primary

Addresses

Primary practice location

1711 S Stephenson Ave Ste 125
Iron Mountain, MI 49801-3649

Mailing address

PO Box 549
Iron Mountain, MI 49801-0549
Phone (906) 774-1313

Other identifiers 4

IdentifierTypeStateIssuer
0802243952OtherMIBCBS MI
31333300MedicaidWI
3010109MedicaidMI
080079313OtherMIRR MEDICARE

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1699757286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498010549",
            "telephone_number": "906-774-1313",
            "fax_number": "906-776-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE STE 125",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013649",
            "telephone_number": "906-776-5810",
            "fax_number": "906-228-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "DONALD",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301022733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "0802243952",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31333300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3010109",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080079313",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.