Individual provider Active NPI

Jon Arthur Jacobson, MD

  • Diagnostic Radiology Physician
  • Ann Arbor, MI
National Provider Identifier
1710068952
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301057569 Issued in MI
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

Updated by the provider on Jul 8, 2025

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 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

IdentifierTypeStateIssuer
3445062MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH, NY, DE, CA5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
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
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

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 Hospital, Ann Arbor, MI, CCN 230046

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G80763CAMDDiagnostic Radiology Physician
4301057569MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Radiology Associates PA Diagnostic Radiology CurrentSince Jan 2, 2023 Accepting new patients
University of Cincinnati Physicians Company, LLC CurrentSince Aug 1, 2021 Accepting new patients
Regents of the University of California Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Hudson Valley Radiology Associates PLLC Diagnostic Radiology CurrentSince Aug 18, 2022 Accepting new patients
Metropolitan Hospital CurrentSince Dec 1, 2017 Accepting new patients
Regents of the University of Michigan Diagnostic Radiology CurrentSince Jun 24, 2025 Accepting new patients
Regents of the University of Michigan Current Accepting new patients
Lenox Hill Radiology & Medical Imaging Associates, PC Diagnostic Radiology CurrentSince Aug 18, 2022 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 PastSince Jul 1, 2008 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.

View all 13

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.