NPIMap

Individual provider Active NPI

Jeffrey Eric Jacobson, DO

  • Psychiatry Physician
  • Des Moines, IA
National Provider Identifier
1841452919
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DO-06395 Issued in IA
Practice address
1111 6TH Ave
Des Moines, IA 50314-2613
Phone
(515) 247-4240
Fax
(515) 247-4239
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 56928 MN
Psychiatry Physician 2084P0800X OS017907 PA
Psychiatry Physician 2084P0800X MT200309 PA
Psychiatry Physician 2084P0800X DO-06395 IA Primary

Addresses

Primary practice location

1111 6TH Ave
Des Moines, IA 50314-2613

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 247-4240

Other practice location 1

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-4786

Other identifiers 2

IdentifierTypeStateIssuer
04358389MedicaidNY
1030976690001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjacobson59776@direct-guthrie.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, PA, NY3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20120822000464 IA Practitioner - Psychiatry 5991952269 Reassigns benefits to 1 organization
I20160111002237 PA Practitioner - Psychiatry 5991952269 Reassigns benefits to 2 organizations
I20220419000913 NY Practitioner - Psychiatry 5991952269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Robert Packer HospitalGroup PAC ID 8022915180, 53 clinicians
Family Services of Chemung County IncGroup PAC ID 2365332236, 13 clinicians
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 268-4809

1019 E Water St
Elmira, NY 14901-3332
Phone (607) 733-5696

1111 6TH Ave
Des Moines, IA 50314-2613
Phone (515) 247-4240

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56928MNMDPsychiatry Physician
MT200309PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group PC Current Accepting new patients
Family Services of Chemung County, Inc. Psychiatry CurrentSince May 3, 2025 Accepting new patients
Robert Packer Hospital CurrentSince Nov 14, 2015 Accepting new patients
Robert Packer Hospital CurrentSince Nov 14, 2015 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Mercy Clinics, Inc. CurrentSince Aug 30, 2023 Accepting new patients
Mercy Clinics, Inc. Current Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Mar 1, 2017 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Mar 1, 2017 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jan 11, 2022 Accepting new patients
Mercy Clinics, Inc Psychiatry CurrentSince Aug 30, 2023 Accepting new patients
State University of Iowa PastSince Jul 1, 2012 Accepting new patients

Locations

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

1019 E Water St
Elmira, NY 14901
Phone (607) 733-5696

3344 Chambers Rd
Horseheads, NY 14845
Phone (607) 734-2264

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: jjacobson3947817@direct.trinity-health.org

Organizations & group practices 12

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 6

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": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1841452919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-247-4240",
            "fax_number": "515-247-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 6TH AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142613",
            "telephone_number": "515-247-4240",
            "fax_number": "515-247-4239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551012502",
            "country_code": "US",
            "telephone_number": "651-254-4786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "JEFFREY",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "56928",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS017907",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MT200309",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "DO-06395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04358389",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030976690001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjacobson59776@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1 Guthrie Sq",
            "city": "Sayre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "188401625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.