Individual provider Active NPI

Paul Allen Jacobs, M.D.

  • Obstetrics & Gynecology Physician
  • Edgewood, KY
National Provider Identifier
1841295243
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
32034 Issued in KY
Practice address
20 Medical Village Dr
Ste 302
Edgewood, KY 41017-5402
Phone
(859) 341-2510
Fax
(859) 578-5888
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 35. 070588 OH
Obstetrics & Gynecology Physician 207V00000X 32034 KY Primary

Addresses

Primary practice location

20 Medical Village Dr
Ste 302
Edgewood, KY 41017-5402

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 341-2510

Other identifiers 1

IdentifierTypeStateIssuer
7100172830MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20100415000480 KY Practitioner - Obstetrics/Gynecology 6305973884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Kentucky College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

6105 1St Financial Dr
Burlington, KY 41005-7892
Phone (859) 301-5901

Hospital & facility affiliations

  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
  • St Elizabeth Florence Hospital, Florence, KY, CCN 180045

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32034KYMDObstetrics & Gynecology Physician
35. 070588OHMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Obstetrics & Gynecology CurrentSince Apr 24, 2023 Accepting new patients
Summit Medical Group, Inc. CurrentSince Apr 24, 2023 Accepting new patients
St Elizabeth Medical Center, Inc Past Accepting new patients

Locations

6105 1st Financial Dr
Burlington, KY 41005
Phone (859) 525-1846

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

20 Medical Village Dr
Edgewood, KY 41017
Phone (859) 344-1600

20 Medical Village Dr
Ste 302
Edgewood, KY 41017
Phone (606) 341-2510

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: pjacobs27060@direct-prd.stelizabeth.com
  • Direct secure messaging: pjacobs@shwhc.gwaydirect.com

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1841295243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-341-2510",
            "fax_number": "859-578-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEDICAL VILLAGE DR",
            "address_2": "STE 302",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175402",
            "telephone_number": "859-341-2510",
            "fax_number": "859-578-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "PAUL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35. 070588",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "32034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100172830",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.