Active NPI
Kyle G Jacobsen, MD
- Anesthesiology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 2018015582
- Practice address
- 1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003 - Phone
- (314) 362-2330
- Fax
- (314) 747-1070
- NPI assigned
- Jul 21, 2014
- Last updated
- May 24, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 2018015582 | MO | Primary |
Addresses
Primary practice location
1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003
Mailing address
660 S Euclid Ave
CB 8054
Saint Louis, MO 63110-1010
Phone (314) 362-2330
Other practice location 1
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | MISSOURI BAPTIST MEDICAL CENTER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Washington University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Missouri Baptist Medical Center
Practice addresses (Care Compare)
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Anesthesia LLC | Anesthesiology | Current | Accepting new patients |
| Parkway Pathology Group, Inc. | Current | Accepting new patients | |
| Missouri Baptist Medical Center | Current | Accepting new patients | |
| Missouri Baptist Medical Center | Anesthesiology | Current | Accepting new patients |
Locations
14825 North Outer 40 Rd
Ste 100
Chesterfield, MO 63017
Phone (636) 898-4695
3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330
Interoperability endpoints
- https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 4
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.
-
- General Practice Physician
- Saint Louis, MO
- NPI 1467461434
-
- Anesthesiology Physician
- Saint Louis, MO
- NPI 1609658905
-
- Anesthesiology Physician
- Saint Louis, MO
- NPI 1225073828
-
- Anatomic Pathology & Clinical Pathology Physician
- Saint Louis, MO
- NPI 1245206960
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1487663506
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716508800000",
"number": "1740697879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 S EUCLID AVE",
"address_2": "CB 8054",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101010",
"telephone_number": "314-362-2330",
"fax_number": "314-747-1070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BARNES JEWISH HOSPITAL PLZ",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101003",
"telephone_number": "314-362-2330",
"fax_number": "314-747-1070"
}
],
"practiceLocations": [
{
"address_1": "3015 N Ballas Rd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631312329",
"country_code": "US",
"telephone_number": "314-996-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBSEN",
"first_name": "KYLE",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-21",
"last_updated": "2024-05-24",
"certification_date": "2024-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MO",
"license": "2018015582",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"endpointDescription": "BJC",
"affiliationName": "MISSOURI BAPTIST MEDICAL CENTER",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3015 N Ballas Rd",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631312329",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.