Dianne R Jacobetz, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD066462L Issued in PA

Practice address

801 Ostrum St
Bethlehem, PA 18015-1000

Phone

(610) 954-3060

NPI assigned

Sep 17, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St. Luke's Physician Group, Inc.

  dba South Mountain Family Practice

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment NPD
• St Luke's Physician Group Inc

  dba St. Luke's Primary Care Orwigsburg

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD
• St. Luke's Physician Group, Inc.

  • Neurology Physician
  • Bethlehem, PA
  • NPI 1588755425
  NPD
• St Luke's Hospital

  dba St. Luke's Hospital - Anderson Campus

  • General Acute Care Hospital
  • Easton, PA
  • NPI 1376339226
  NPD (past)
• St Lukes Hospital-Anderson Campus

  • General Acute Care Hospital
  • Easton, PA
  • NPI 1497050470
  NPD (past)
• St. Luke's Hospital

  dba St. Luke's Hospital - Allentown Campus

  • General Acute Care Hospital
  • Allentown, PA
  • NPI 1548293954
  NPD (past)
• St. Luke's Physician Group, Inc.

  • Maternal & Fetal Medicine Physician
  • Fountain Hill, PA
  • NPI 1003867623
  NPD (past)

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790882447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 E BROAD ST",
            "address_2": "2ND FLR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186332",
            "telephone_number": "610-954-6048",
            "fax_number": "610-954-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "610-954-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBETZ",
        "first_name": "DIANNE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD066462L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017912780003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shateffa Jackson
• Jeena Mary Jacob, M.D
• Mervana Jacob, DMD
• Sharon Leigh Jacob, M.D.
• Tiffany Kristen Jacob, M.S., LPC
• Cameron R Jacobs, DO
• Joseph M Jacobs, MD
• Travus A. Jadus, CRNA
• Daniela Luisa Jaeger, MD
• Randy Jaeger, M.D.

• Pediatrics Physician in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.