NPIMap

Individual provider Active NPI

Peter C Jacobson, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Virginia Beach, VA
National Provider Identifier
1770505703
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
0101041104 Issued in VA
Practice address
1849 Old Donation Pkwy
Virginia Beach, VA 23454-3004
Phone
(757) 422-8476
Fax
(757) 213-4332
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 0101041104 VA Primary

Addresses

Primary practice location

1849 Old Donation Pkwy
Virginia Beach, VA 23454-3004

Mailing address

1115 Boulders Pkwy Ste 200
North Chesterfield, VA 23225-4067
Phone (804) 560-5595

Other identifiers 1

IdentifierTypeStateIssuer
6409628MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pjacobson17484@direct.orthovirginia.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20120228000278 VA Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 2860575958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Vanderbilt University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthovirginia IncGroup PAC ID 0547157224, 570 clinicians

Practice addresses (Care Compare)

1115 Boulders Pkwy
North Chesterfield, VA 23225-4067

1717 Will O Wisp Dr
Suite 100
Virginia Beach, VA 23454-3102
Phone (757) 422-8476

667 Kingsborough SQ
Suite 300
Chesapeake, VA 23320-4999
Phone (757) 422-5476

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.85 of 100Reported as group
Quality
90.74
Promoting interoperability
100
Improvement activities
40
Cost
78.74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement17
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Orthovirginia Inc Current Accepting new patients
Orthovirginia, Inc CurrentSince Jan 1, 2019 Accepting new patients
Vann-Virginia Center for Orthopaedics PC Past Accepting new patients
Vann-Virginia Center for Orthopaedics PC Past Accepting new patients
Orthovirginia, Inc. Past Accepting new patients

Locations

8200 Meadowbridge Rd
Ste 200
Mechanicsville, VA 23116
Phone (804) 560-5595

1115 Boulders Pkwy
Ste 200
North Chesterfield, VA 23225
Phone (804) 327-9242

1717 Will O Wisp Dr
Ste 100
Virginia Beach, VA 23454
Phone (757) 422-8476

1849 Old Donation Pkwy
Virginia Beach, VA 23454
Phone (757) 422-8476

Organizations & group practices 5

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1770505703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BOULDERS PKWY STE 200",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232254067",
            "telephone_number": "804-560-5595",
            "fax_number": "804-560-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 OLD DONATION PKWY",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543004",
            "telephone_number": "757-422-8476",
            "fax_number": "757-213-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "PETER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "VA",
            "license": "0101041104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6409628",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pjacobson17484@direct.orthovirginia.com",
            "affiliation": "N",
            "endpointDescription": "Dr. Jacobson direct address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "secure messaging",
            "address_1": "1849 Old Donation Pkwy",
            "city": "Virginia Beach",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234543004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.