Active NPI
Jon Arthur Jacobson, MD
- Diagnostic Radiology Physician
- Ann Arbor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 4301057569
- Practice address
- 1500 E Medical Center Dr
Ann Arbor, MI 48109-5000 - Phone
- (734) 936-4000
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 35.142301 | OH | |
| Diagnostic Radiology Physician | 2085R0202X | G80763 | CA | |
| Diagnostic Radiology Physician | 2085R0202X | 4301057569 | MI | Primary |
Addresses
Primary practice location
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Mailing address
3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299
Other practice location 1
200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3445062 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, OH, NY, DE, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 5
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040216000995 | MI | Practitioner - Diagnostic Radiology | 1850286295 | Reassigns benefits to 4 organizations |
| I20210614003271 | OH | Practitioner - Diagnostic Radiology | 1850286295 | Reassigns benefits to 1 organization |
| I20220921003700 | NY | Practitioner - Diagnostic Radiology | 1850286295 | Reassigns benefits to 2 organizations |
| I20230127000482 | DE | Practitioner - Diagnostic Radiology | 1850286295 | Reassigns benefits to 1 organization |
| I20230406001918 | CA | Practitioner - Diagnostic Radiology | 1850286295 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Wayne State University School of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000
Hospital & facility affiliations
- University of Michigan Health System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G80763 | CA | MD | Diagnostic Radiology Physician |
| 4301057569 | MI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delaware Radiology Associates PA | Diagnostic Radiology | Current | Accepting new patients |
| University of Cincinnati Physicians Company, LLC | Current | Accepting new patients | |
| Regents of the University of California | Diagnostic Radiology | Current | Accepting new patients |
| Hudson Valley Radiology Associates PLLC | Diagnostic Radiology | Current | Accepting new patients |
| Metropolitan Hospital | Current | Accepting new patients | |
| Regents of the University of Michigan | Diagnostic Radiology | Current | Accepting new patients |
| Regents of the University of Michigan | Current | Accepting new patients | |
| Lenox Hill Radiology & Medical Imaging Associates, PC | Diagnostic Radiology | Current | Accepting new patients |
| Regents of the University of Michigan | Past | Accepting new patients | |
| Regents of the University of California | Past | Accepting new patients | |
| Regents of the University of California Ucsd Head and Neck Surgery | Past | Accepting new patients | |
| Park West Radiology, PC | Diagnostic Radiology | Past | Accepting new patients |
| Koniver Fiss Mansoory MD PA | Diagnostic Radiology | Past | Accepting new patients |
Locations
9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000
200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754
330 Lewis St
Ste 400
San Diego, CA 92103
Phone (619) 471-9250
4250 1st Ave
San Diego, CA 92103
Phone (415) 290-8175
40 Polly Drummond Hill Rd
Bldg 4
Newark, DE 19711
Phone (302) 737-5990
3401 Brandywine Pkwy
Ste 102
Wilmington, DE 19803
Phone (302) 533-2160
29493 Network Pl
Chicago, IL 60673
27443 Network Pl
Chicago, IL 60673
1500 E Medical Center Dr
Fl 2
Ann Arbor, MI 48109
Phone (734) 936-5738
1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280
3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229
3621 S State St
#700
Ann Arbor, MI 48108
1500 E Medical Center Dr
#D
Ann Arbor, MI 48109
Phone (734) 936-5823
5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243
9 Bond St
Fl 4
Brooklyn, NY 11201
Phone (718) 222-0202
8940 56th Ave
Flushing, NY 11373
Phone (718) 335-5532
18 Squadron Blvd
New City, NY 10956
Phone (845) 368-3002
315 W 57th St
Ste LL4
New York, NY 10019
Phone (212) 698-5300
61 E 77th St
New York, NY 10075
Phone (212) 772-2130
111 N Highland Ave
Nyack, NY 10960
Phone (845) 639-6178
2830 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 245-3335
2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523
3199 Highland Ave
Cincinnati, OH 45219
Phone (513) 475-7777
3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281
Organizations & group practices 13
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.
-
- Diagnostic Radiology Physician
- Newark, DE
- NPI 1740706175
DE, Diagnostic Radiology
-
- Diagnostic Radiology Physician
- New City, NY
- NPI 1174574115
Diagnostic Radiology, MI, NY
-
- Diagnostic Radiology Physician
- New York, NY
- NPI 1821036807
Diagnostic Radiology, MI, NY
-
- Diagnostic Radiology Physician
- San Diego, CA
- NPI 1558463927
CA, Diagnostic Radiology
-
- Family Medicine Physician
- Cincinnati, OH
- NPI 1801840434
OH
-
- Diagnostic Radiology Physician
- Ann Arbor, MI
- NPI 1871528026
Diagnostic Radiology
-
- General Acute Care Hospital
- Ann Arbor, MI
- NPI 1003878539
-
- Diagnostic Radiology Physician
- Wilmington, DE
- NPI 1083615561
Diagnostic Radiology
-
- Diagnostic Ultrasound Physician
- New York, NY
- NPI 1003855404
Diagnostic Radiology
-
- Pharmacy
- San Diego, CA
- NPI 1598786576
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Ann Arbor, MI
- NPI 1003878539
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751932800000",
"number": "1710068952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481081633",
"telephone_number": "734-647-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E MEDICAL CENTER DR",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481095000",
"telephone_number": "734-936-4000"
}
],
"practiceLocations": [
{
"address_1": "200 W Arbor Dr",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921039000",
"country_code": "US",
"telephone_number": "800-926-8273",
"fax_number": "888-539-8781",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBSON",
"first_name": "JON",
"middle_name": "ARTHUR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2025-07-08",
"certification_date": "2025-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OH",
"license": "35.142301",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "G80763",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "4301057569",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3445062",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.