Individual provider Active NPI

Laura Jacobs, PA

  • Physician Assistant
  • Saratoga Springs, NY
National Provider Identifier
1780876045
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002791 Issued in NY
Practice address
454 Maple Ave
Saratoga Springs, NY 12866-5532
Phone
(518) 587-1141
Fax
(518) 587-1152
NPI assigned
Aug 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0130 NH
Physician Assistant 363A00000X 002791 NY Primary

Addresses

Primary practice location

454 Maple Ave
Saratoga Springs, NY 12866-5532

Mailing address

454 Maple Ave
Saratoga Springs, NY 12866-5532
Phone (518) 587-1141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0130NHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince Jul 24, 2014 Accepting new patients
Saratoga Hospital CurrentSince Jul 19, 2012 Accepting new patients
Saratoga Hospital CurrentSince Jul 19, 2012 Accepting new patients
Albany Medical College CurrentSince Jul 24, 2014 Accepting new patients
Albany Medical College CurrentSince Aug 12, 2014 Accepting new patients
The New London Hospital Association, Inc. Past Accepting new patients

Locations

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

115 Saratoga Rd
Ste 110
Schenectady, NY 12302
Phone (518) 264-2900

11835 Route 9W
West Coxsackie, NY 12192
Phone (518) 731-9000

Interoperability endpoints

  • Direct secure messaging: ljacobs39724@albanymed.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1780876045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 MAPLE AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128665532",
            "telephone_number": "518-587-1141",
            "fax_number": "518-587-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 MAPLE AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128665532",
            "telephone_number": "518-587-1141",
            "fax_number": "518-587-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "LAURA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "0130",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "002791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.