Dan Jacobs, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

OS002982L Issued in PA

Practice address

550 Pinetown Rd
Ste 350
Fort Washington, PA 19034-2605

Phone

(215) 643-0200

Fax

(215) 643-9844

NPI assigned

Mar 19, 2007

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 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

Specialty

Psychiatry

Education

Philadelphia College of Osteopathic Medicine, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Care ConnectionGroup PAC ID 8628982386, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Care Connection

  • Mental Health Counselor
  • Philadelphia, PA
  • NPI 1952351660
  Medicare reassignment Care Compare group
• Ketan Patel MDPC

  • Psychiatry Physician
  • North Wales, PA
  • NPI 1275705345
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1831213263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PINETOWN RD",
            "address_2": "STE 350",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342605",
            "telephone_number": "215-643-0200",
            "fax_number": "215-643-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PINETOWN RD",
            "address_2": "STE 350",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342605",
            "telephone_number": "215-643-0200",
            "fax_number": "215-643-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "DAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS002982L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00784063",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marianne E. Intoccia, PHD
• Julia Frida Ioffe
• Iuoe Local 542 Health Center
• Christian Iversen, MD
• Abbigayle Jackson, OTR/L, OTD
• Karen R Jacobson, LCSW
• Janus Medical Associates
• Mildred Jean-Philippe Telusma, LPN
• Suze Jeantine
• Margarita Jimenez

• Psychiatry Physician in Fort Washington, PA
• Providers in Fort Washington, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.