Jacob D Light, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD181929 Issued in OR

Practice address

707 SW Washington St Ste 700
Portland, OR 97205-3523

Phone

(503) 299-9906

Fax

(503) 225-9002

NPI assigned

Apr 9, 2013

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in AK, CO2 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 2

Specialty

Anesthesiology

Education

University of Colorado School of Medicine, Denver, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Timberline Anesthesia Partners LLCGroup PAC ID 7719361104, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Montrose Regional Health Hospital, Montrose, CO, CCN 060006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Timberline Anesthesia Partners LLC

  • Anesthesiology Physician
  • Montrose, CO
  • NPI 1366179012
  Medicare reassignment Care Compare group
• Denali Anesthesia, LLC

  • Anesthesiology Physician
  • Anchorage, AK
  • NPI 1508854712
  Medicare reassignment NPD
• Corvallis Radiology PC

  • Diagnostic Radiology Physician
  • Corvallis, OR
  • NPI 1881651289
  NPD (past)
• Oag Trauma Services LLC

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1548669948
  NPD (past)

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

• Montrose Memorial Hospital, Inc

  • General Acute Care Hospital
  • Montrose, CO
  • NPI 1205822186
  Care Compare affiliation

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1730522798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35147",
            "address_2": "#1801",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245147",
            "telephone_number": "503-299-9906",
            "fax_number": "503-225-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SW WASHINGTON ST STE 700",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972053523",
            "telephone_number": "503-299-9906",
            "fax_number": "503-225-9002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "JACOB",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-09",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD181929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500729768",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lifeworks NW
• Light Mind Wellness
• Light Side Wellness Co.
• Light Within Therapy LLC
• Gretchen Elizabeth Light, MA
• Lindi Jo Fawn Light, QMHA
• Michael L Lightfoot
• Katie Lighthart, AU.D.
• Emily Lighthipe, DPT
• Lighthouse Counseling Center LLC

• Anesthesiology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Anesthesiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.