Brian J Jacobs, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

36114383 Issued in IL

Practice address

1800 Hollister Dr
Suite 111
Libertyville, IL 60048-5263

Phone

(847) 573-9055

Fax

(847) 573-1790

NPI assigned

Apr 27, 2006

Last updated

Mar 28, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 4

Medicare fee-for-service enrollment

Enrolled in IL

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

Ophthalmology

Education

Rush Medical College of Rush University, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Center Physicians, LTD.Group PAC ID 2567411325, 36 clinicians

M.L. Savitt IncGroup PAC ID 1456362722, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
• Rush University Medical Center Hospital, Chicago, IL, CCN 140119

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bjacobs4196@direct.rush.rush-health.com
• Direct secure messaging: brianjacobs@nsgc.direct.eyemdemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eye Center Physicians, LTD.

  • Ophthalmology Physician
  • Chicago, IL
  • NPI 1992715650
  Medicare reassignment Care Compare group NPD
• M.L. Savitt Inc

  dba North Shore Glaucoma Center

  • Ophthalmology Physician
  • Libertyville, IL
  • NPI 1669424974
  Medicare reassignment Care Compare group NPD

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

• Advocate Condell Medical Center

  dba Advocate Condell Imaging Center

  • Mobile Mammography Clinic/Center
  • Gurnee, IL
  • NPI 1023262441

  Hospital

  Care Compare affiliation
• Advocate Condell Medical Center

  • General Acute Care Hospital
  • Libertyville, IL
  • NPI 1124272547
  Care Compare affiliation
• Advocate Condell Medical Center

  dba Advocate Condell Medical Center Grays Lake

  • Mobile Mammography Clinic/Center
  • Grayslake, IL
  • NPI 1770737199

  Hospital

  Care Compare affiliation
• Rush University Medical Center

  • Children's Hospital
  • Chicago, IL
  • NPI 1801908728
  Care Compare affiliation
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  Care Compare affiliation

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1730146218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HOLLISTER DR",
            "address_2": "SUITE 111",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485263",
            "telephone_number": "847-573-9055",
            "fax_number": "847-573-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HOLLISTER DR",
            "address_2": "SUITE 111",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485263",
            "telephone_number": "847-573-9055",
            "fax_number": "847-573-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "36114383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36114383",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDIARE",
            "identifier": "P00321248",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2",
            "affiliation": "N",
            "address_1": "1800 Hollister Dr",
            "address_2": "Suite 111",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485263",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bjacobs237940@directmyadvocateaurora.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1800 Hollister Dr",
            "address_2": "Suite 111",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485263",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bjacobs237940@directmyadvocateaurora.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1800 Hollister Dr",
            "address_2": "Suite 111",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485263",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brianjacobs@nsgc.direct.eyemdemr.com",
            "affiliation": "N",
            "endpointDescription": "brianjacobs@nsgc.direct.eyemdemr.com",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1800 Hollister Dr Ste 205",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bruce William Irwin, M.D.
• Leisel Iverson, ATC
• Alisha Jacob, FNP-C
• Reena Jacob, DC
• Sapna Jacob, MD
• Lisa Jacobsen
• Scott Jacobsen, DPM
• Nicole Jacques, LSW
• Rachael Jaffe
• Amunn Jaffery, LSW

• Ophthalmology Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.