Brent Jacobsen, D.O

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

20A8142 Issued in CA

Practice address

36485 Inland Valley Dr
Wildomar, CA 92595-9681

Phone

(909) 677-9773

NPI assigned

Aug 20, 2006

Sex

Male

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 CA

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

Specialty

Emergency Medicine

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Em Alliance California ApcGroup PAC ID 1951749894, 68 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southwest Healthcare Rancho Springs Hospital Hospital, Murrieta, CA, CCN 050701

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Em Alliance California, Apc

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1376305755
  Medicare reassignment Care Compare group NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Medical Emergency Treatment Corporation

  • Emergency Medicine Physician
  • Maumee, OH
  • NPI 1437111861
  NPD (past)

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

• Universal Health Services of Rancho Springs Inc

  dba Southwest Healthcare - Inland Valley Hospital

  • General Acute Care Hospital
  • Murrieta, CA
  • NPI 1245221050
  Care Compare affiliation

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1790890465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36485 INLAND VALLEY DR",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959681",
            "telephone_number": "909-677-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "BRENT",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A8142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX814200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inscriptions Children's Clinic
• Tynan Ipaye
• John Ippolito, PHARMACIST
• Sarah Jacob
• Randolph J Jacobs, M.D.
• Bryanna Jaime
• James Hoch DDS PC
• Alyssa James
• Madalyn Jasper, DPT
• Ty'Jae Jenkins

• Emergency Medicine Physician in Wildomar, CA
• Providers in Wildomar, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.
• 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.