Jacobson Plastic Surgery LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

43676 Issued in MN

Legal business name

JACOBSON PLASTIC SURGERY LLC

Practice address

2518 Superior Dr NW
Ste 104
Rochester, MN 55901-1988

Phone

(952) 303-2100

NPI assigned

Aug 9, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Steven R Jacobson, MDNPI 1104899830

Title

Owner

Phone

(952) 303-2100

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven R Jacobson, M.D.

  • Plastic Surgery Physician
  • Rochester, MN
  • NPI 1104899830
  NPD (past) Authorized official

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1750835690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 SUPERIOR DRIVE NW",
            "address_2": "STE 104",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55902",
            "telephone_number": "952-303-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2518 SUPERIOR DR NW",
            "address_2": "STE 104",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011988",
            "telephone_number": "952-303-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOBSON PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-303-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MN",
            "license": "43676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053825600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1104899830",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron Isaac Jacobs, PHD
• Elisha R Jacobs, RN, CNP
• Travis M Jacobs, MD
• Katherine M Jacobsen, CRNA
• Vicki L Jacobsen, M.D.
• Alicia Rubin Jacobson, MD
• Janalene L Jacobson, AUD
• Jenna Michelle Jacobson, PA
• Madison Ann Jacobson, PA-C
• Marcus P Jacobson, PA

• Specialist in Rochester, MN
• Providers in Rochester, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.