NPIMap

Individual provider Active NPI

Michael Brian Jacobson, MD

  • Pediatrics Physician
  • El Cajon, CA
National Provider Identifier
1831284249
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A88422 Issued in CA
Practice address
250 E Chase Ave
Suite 108
El Cajon, CA 92020-6305
Phone
(619) 442-2560
Fax
(619) 442-7836
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A88422 CA Primary

Addresses

Primary practice location

250 E Chase Ave
Suite 108
El Cajon, CA 92020-6305

Mailing address

250 E Chase Ave
Suite 108
El Cajon, CA 92020-6305
Phone (619) 442-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A88422CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients
Rady Children'S Hospital San Diego Past Accepting new patients
Scripps Health Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mjacobson10769@radychildrens.direct-ci.com
  • Direct secure messaging: mjacobson43079@scrippshlth.medalliesdirect.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296518400000",
    "number": "1831284249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E CHASE AVE",
            "address_2": "SUITE 108",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920206305",
            "telephone_number": "619-442-2560",
            "fax_number": "619-442-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E CHASE AVE",
            "address_2": "SUITE 108",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920206305",
            "telephone_number": "619-442-2560",
            "fax_number": "619-442-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "MICHAEL",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A88422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; 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.