Thomas Larue Jacobs, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

201707769NP-PP Issued in OR

Practice address

475 S Columbia River Hwy Ste 105
Saint Helens, OR 97051-2860

Phone

(503) 397-7119

NPI assigned

Aug 14, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
• Columbia Basin Hospital Hospital, Ephrata, WA, CCN 501317
• East Adams Rural Hospital Hospital, Ritzville, WA, CCN 501311
• Hillsboro Medical Center Hospital, Hillsboro, OR, CCN 380021

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjacobs136905@direct.ohsu.edu

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.

• University Professional Services

  • General Practice Physician
  • Portland, OR
  • NPI 1376709535
  Medicare reassignment Care Compare group NPD
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  Medicare reassignment NPD
• Oregon Health & Science University

  • Rural Health Clinic/Center
  • Scappoose, OR
  • NPI 1417969304
  Medicare reassignment NPD
• Tuality Medical Group LLC

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1073929782
  Medicare reassignment NPD
• Adams County Public Hospital District 3

  • Critical Access Hospital
  • Othello, WA
  • NPI 1811108822
  Medicare reassignment NPD
• Grant County Public Hospital District 3

  • Emergency Medical Services (Emergency Medicine) Physician
  • Ephrata, WA
  • NPI 1134283930
  Medicare reassignment NPD
• Legacy Emanuel Hospital & Health Center

  • Rural Health Clinic/Center
  • Saint Helens, OR
  • NPI 1316129232
  NPD
• Legacy Emanuel Hospital & Health Center

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1417977976
  NPD
• Oregon Health & Science University

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1457129678
  NPD
• Tuality Medical Group LLC

  • Neurology Physician
  • Hillsboro, OR
  • NPI 1639690704
  NPD
• University Professional Services

  • Pharmacy
  • Beaverton, OR
  • NPI 1073054714
  NPD
• Adams County Hospital 2

  • Rural Health Clinic/Center
  • Ritzville, WA
  • NPI 1659387041
  NPD (past)

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

• Oregon Health & Science University

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1609824010
  Care Compare affiliation
• Tuality Healthcare

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1023130978

  Hospital

  Care Compare affiliation
• Tuality Healthcare

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1043433956

  Hospital

  Care Compare affiliation
• Tuality Healthcare

  • Psychiatric Hospital
  • Hillsboro, OR
  • NPI 1073817714
  Care Compare affiliation
• Tuality Healthcare

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1104194315

  Hospital

  Care Compare affiliation
• Tuality Healthcare

  • General Acute Care Hospital
  • Hillsboro, OR
  • NPI 1275591984
  Care Compare affiliation
• Tuality Healthcare

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1356647168

  Hospital

  Care Compare affiliation
• Tuality Healthcare

  • Infusion Therapy Clinic/Center
  • Hillsboro, OR
  • NPI 1366748733

  Hospital

  Care Compare affiliation
• Tuality Healthcare

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1790053700

  Hospital

  Care Compare affiliation
• Tuality Healthcare

  • Clinic/Center
  • Forest Grove, OR
  • NPI 1851515969

  Hospital

  Care Compare affiliation
• Tuality Healthcare

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1902016371

  Hospital

  Care Compare affiliation
• Tuality Healthcare

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1952607970

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1790201598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29134 OLD RAINIER RD",
            "city": "RAINIER",
            "state": "OR",
            "postal_code": "970482300",
            "telephone_number": "360-818-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 S COLUMBIA RIVER HWY STE 105",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970512860",
            "telephone_number": "503-397-7119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 NE Mother Joseph Pl",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986643200",
            "country_code": "US",
            "telephone_number": "360-514-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Encore Wellness 4 Life 135 Vista Way, Suite E",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "993363200",
            "country_code": "US",
            "telephone_number": "509-987-1099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Encore Wellness 4 Life 1890 7th St",
            "address_purpose": "LOCATION",
            "city": "Umatilla",
            "state": "OR",
            "postal_code": "978823200",
            "country_code": "US",
            "telephone_number": "541-922-1750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "NOC Medical Clinic",
            "address_2": "12 Acre Pad, Oliktok Road",
            "address_purpose": "LOCATION",
            "city": "Prudhoe Bay",
            "state": "AK",
            "postal_code": "997340000",
            "country_code": "US",
            "telephone_number": "907-685-1420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "THOMAS",
        "middle_name": "LARUE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-14",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60785555",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "153353",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201707769NP-PP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201707769NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larissa Christine Ienna, FNP
• Justin Matthew Irons
• Rebecca A Izbicki
• Jordan Jackson Sr.
• Lacey Jade Jackson
• Todd A Jacobson, LCSW
• Tyrone James
• Robert Hillman Janz, LPC, QMHP
• Georgia Brenteney Jeffreys
• Lucca Jenkins-Law

• Nurse Practitioner in Saint Helens, OR
• Providers in Saint Helens, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.

Verify at the official NPI Registry.