Jacob Jarecke, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

LL86136 Issued in SC

Practice address

169 Ashley Ave RM 202
Charleston, SC 29425-8905

Phone

(843) 792-2322

NPI assigned

May 31, 2021

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

Medicare fee-for-service enrollment

Enrolled in CA, NV2 enrollments

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 2

Specialty

Anesthesiology

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Tahoe Anesthesia Medical GroupGroup PAC ID 5698748663, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Barton Memorial Hospital Hospital, South Lake Tahoe, CA, CCN 050352

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• South Tahoe Anesthesia Medical Group

  • Pain Medicine (Anesthesiology) Physician
  • South Lake Tahoe, CA
  • NPI 1962513770

  NV

  Medicare reassignment Care Compare group NPD

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

• Barton Healthcare System

  • General Acute Care Hospital
  • South Lake Tahoe, CA
  • NPI 1003867565
  Care Compare affiliation

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

{
    "created_epoch": "1622419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622419200000",
    "number": "1871169953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE RM 202",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE RM 202",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARECKE",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-31",
        "last_updated": "2021-05-31",
        "certification_date": "2021-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "LL86136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Jandali
• Deeksha Jandhyala, M.D.
• Jeffrey Janecek
• Jarcarte,Inc
• Amy Jardin
• Lauren Grace Jarman, ACNPC-AG
• Sheldon Craig Jarmon
• Amber M Jarnecke, PHD
• Beth Ann Jarowyi, RDH, CDA
• Courtney E Jarrard, OT

• Anesthesiology Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Anesthesiology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2021; 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.