Active NPI
Grace L Jacobsen, PA
- Physician Assistant
- Anchorage, AK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 209899
- Practice address
- 3841 Piper St Ste T100
Anchorage, AK 99508-4674 - Phone
- (907) 561-3211
- Fax
- (907) 771-6715
- NPI assigned
- Jul 20, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 209899 | AK | Primary |
Addresses
Primary practice location
3841 Piper St Ste T100
Anchorage, AK 99508-4674
Mailing address
3841 Piper St Ste T100
Anchorage, AK 99508-4674
Phone (907) 550-2233
Other practice location 1
3643 N Roxboro St
Durham, NC 27704-2702
Phone (919) 470-4000
Other names 1
- Grace L Johnson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Duke University School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2751 Debarr Rd
Suite B200
Anchorage, AK 99508-6813
Phone (907) 561-3211
2801 Debarr Rd
Anchorage, AK 99508-2932
Phone (907) 561-3211
3200 Providence Dr
Anchorage, AK 99508-4615
Phone (907) 561-3211
Hospital & facility affiliations
- Providence Alaska Medical Center
- Alaska Regional Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209899 | AK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duke University Health System, Inc. | Current | Accepting new patients | |
| Alaska Heart Institute | Current | Accepting new patients | |
| Duke University Health System, Inc. | Current | Accepting new patients |
Locations
3841 Piper St
Anchorage, AK 99508
Phone (907) 563-3103
3841 Piper St
Ste T100
Anchorage, AK 99508
Phone (907) 550-2233
2751 Debarr Rd
Ste B200
Anchorage, AK 99508
3125 E Meridian Park Loop
Ste 200
Wasilla, AK 99654
5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700
3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186
Organizations & group practices 3
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.
-
- Cardiovascular Disease Physician
- Anchorage, AK
- NPI 1992744114
-
- Parenteral & Enteral Nutrition Supplies (DME)
- Durham, NC
- NPI 1427187525
-
- Internal Medicine Physician
- Durham, NC
- NPI 1962721308
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Anchorage, AK
- NPI 1952348047
-
- General Acute Care Hospital
- Anchorage, AK
- NPI 1053363119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693526400000",
"number": "1801404579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3841 PIPER ST STE T100",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995084674",
"telephone_number": "907-550-2233",
"fax_number": "907-771-6715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3841 PIPER ST STE T100",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995084674",
"telephone_number": "907-561-3211",
"fax_number": "907-771-6715"
}
],
"practiceLocations": [
{
"address_1": "3643 N Roxboro St",
"address_purpose": "LOCATION",
"city": "Durham",
"state": "NC",
"postal_code": "277042702",
"country_code": "US",
"telephone_number": "919-470-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBSEN",
"first_name": "GRACE",
"middle_name": "L",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-20",
"last_updated": "2023-09-01",
"certification_date": "2023-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AK",
"license": "209899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GRACE",
"last_name": "JOHNSON",
"middle_name": "L",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.