Paul Allen Jacobson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

38737 Issued in FL

Practice address

4044 W Lake Mary Blvd
#410
Lake Mary, FL 32746-2012

Phone

(407) 718-8000

NPI assigned

Feb 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• HealthSun Health Plans Network

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1821131780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4044 W LAKE MARY BLVD",
            "address_2": "#410",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462012",
            "telephone_number": "407-718-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4044 W LAKE MARY BLVD",
            "address_2": "#410",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462012",
            "telephone_number": "407-718-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "PAUL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "38737",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME38737",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040565500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael V. Jablonski, M.D.
• Ashton Jack
• Joshuah Jackson
• Mikaela Jackson
• Jacob K Agamasu MD PA
• Pamela Jacques
• Halima Jaffer
• Jagdeep Dhall, D.M.D., P.a.
• Ravindra R Jahagirdar, MD
• Udita R Jahagirdar, M.D.

• Psychiatry Physician in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.