NPIMap

Individual provider Active NPI

James Joseph Jacowski III, ARNP

  • Family Nurse Practitioner
  • Oak Harbor, WA
National Provider Identifier
1730942103
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61506523 Issued in WA
Practice address
275 SE Cabot Dr Ste B101
Oak Harbor, WA 98277-3740
Phone
(360) 675-6648
Fax
(360) 679-9310
NPI assigned
Jan 30, 2024
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61506523 WA Primary

Addresses

Primary practice location

275 SE Cabot Dr Ste B101
Oak Harbor, WA 98277-3740

Mailing address

275 SE Cabot Dr Ste B101
Oak Harbor, WA 98277-3740
Phone (360) 675-6648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240307004208 WA Practitioner - Nurse Practitioner 1658717095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

275 SE Cabot Dr
B101 Whidbeyhealth Primary Care
Oak Harbor, WA 98277-3740
Phone (360) 675-6648

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WGH Primary Care Associates, P.S. Current Accepting new patients
Whidbey Island Public Hospital District CurrentSince Apr 22, 2024 Accepting new patients
Whidbey Island Public Hospital District Current Accepting new patients
Whidbey Island Public Hospital District CurrentSince Apr 22, 2024 Accepting new patients
Whidbey Island Public Hospital District Past Accepting new patients

Locations

275 SE Cabot Dr
Ste B101
Oak Harbor, WA 98277
Phone (360) 675-6648

Organizations & group practices 6

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.

Hospital & facility affiliations 9

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": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1730942103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SE CABOT DR STE B101",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773740",
            "telephone_number": "360-675-6648",
            "fax_number": "360-679-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 SE CABOT DR STE B101",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773740",
            "telephone_number": "360-675-6648",
            "fax_number": "360-679-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOWSKI",
        "first_name": "JAMES",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-01-30",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61506523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

Sources for this page

Verify at the official NPI Registry.