Brent A Jacobus, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02001090 Issued in IN

Practice address

9150 E 109TH Ave Ste 2a
Crown Point
Crown Point, IN 46307-7686

Phone

(219) 226-1529

Fax

(219) 226-2994

NPI assigned

Aug 9, 2005

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 IN

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

Family Practice

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nwi Mdvip LLCGroup PAC ID 0042683690, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dunes Hospice LLC Hospice, Valparaiso, IN, CCN 151614
• The Willows Hospice Hospice, Crown Point, IN, CCN 151673
• St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034
• Pinnacle Hospital Hospital, Crown Point, IN, CCN 150166
• Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126
• Powers Health Rehabilitation Center Inpatient rehabilitation facility, Crown Point, IN, CCN 153045

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Arts, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18290/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
• Direct secure messaging: brent.jacobus@wfml-in.direct.office.nextgen.com

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Pinnacle Healthcare LLC

  • General Acute Care Hospital
  • Crown Point, IN
  • NPI 1801969670

  5% Or Greater Direct Ownership Interest, Other

  CMS ownership
• Willows Holdings LLC

  • Community Based Hospice Care Agency
  • Crown Point, IN
  • NPI 1841184371

  Contracted Managing Employee

  CMS ownership

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.

• Nwi Mdvip LLC

  • Family Medicine Physician
  • Crown Point, IN
  • NPI 1538877972
  Medicare reassignment Care Compare group NPD Authorized official
• Winfield Family Medicine LLC

  • Family Medicine Physician
  • Crown Point, IN
  • NPI 1568413177
  Medicare reassignment NPD Authorized official
• Pinnacle Healthcare, LLC

  • Multi-Specialty Clinic/Center
  • Merrillville, IN
  • NPI 1922546530

  Family Medicine

  Medicare reassignment NPD
• Refuge Clinic, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Crown Point, IN
  • NPI 1548148752
  NPD Authorized official
• Physician Care Solutions P.C.

  • Internal Medicine Physician
  • Troy, MI
  • NPI 1285265983
  NPD
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1962504175
  NPD (past)
• St. Mary Medical Center Inc

  • Family Medicine Physician
  • Merrillville, IN
  • NPI 1598839730
  NPD (past)

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

• Community Stroke and Rehabilitation Center Inc

  • Rehabilitation Hospital
  • Crown Point, IN
  • NPI 1801301437

  Inpatient rehabilitation facility

  Care Compare affiliation
• Dunes Hospice LLC

  • Community Based Hospice Care Agency
  • Valparaiso, IN
  • NPI 1609280015
  Care Compare affiliation
• Franciscan Health Crown Point

  • General Acute Care Hospital
  • Crown Point, IN
  • NPI 1336205798
  Care Compare affiliation
• Pinnacle Healthcare LLC

  • General Acute Care Hospital
  • Crown Point, IN
  • NPI 1801969670
  Care Compare affiliation
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1558463745
  Care Compare affiliation
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1962504175
  Care Compare affiliation
• Willows Holdings LLC

  • Community Based Hospice Care Agency
  • Crown Point, IN
  • NPI 1841184371
  Care Compare affiliation

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1902807589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9150 E 109TH AVE STE 2A",
            "address_2": "CROWN POINT",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077686",
            "telephone_number": "219-226-1529",
            "fax_number": "219-226-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9150 E 109TH AVE STE 2A",
            "address_2": "CROWN POINT",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077686",
            "telephone_number": "219-226-1529",
            "fax_number": "219-226-2994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBUS",
        "first_name": "BRENT",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02001090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100200720",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isaias Jackson Jr., RBT
• Trashaina Jackson
• Katherine Jacobi, FNP-C
• Alisha Jacobs
• Jacobus Family Enterprises LLC
• Ashish Jain, MD
• Jerri Jakich-Ortiz, MS
• Margaret Jakubowicz, NP
• Kevin James, PT, DPT
• Tuanda James, MENTAL HEALTH MS

• Family Medicine Physician in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.