Lisa Waite Jacobson, D.O.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

5101013549 Issued in MI

Practice address

8872 Professional Dr
Cadillac, MI 49601-8481

Phone

(231) 779-6260

Fax

(231) 779-6264

NPI assigned

Feb 22, 2006

Sex

Female

Sole proprietor

Yes

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 MI

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

Otolaryngology

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lisa Jacobson D.O., P.C.Group PAC ID 5496803249, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Lisa Jacobson D.O., P.C.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Cadillac, MI
  • NPI 1831333715
  Medicare reassignment Care Compare group NPD Authorized official

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

• Munson Healthcare Cadillac

  • Family Medicine Physician
  • Cadillac, MI
  • NPI 1487051611

  Hospital

  Care Compare affiliation
• Munson Healthcare Cadillac

  • General Acute Care Hospital
  • Cadillac, MI
  • NPI 1841696754
  Care Compare affiliation

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1922073766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8872 PROFESSIONAL DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018481",
            "telephone_number": "231-779-6260",
            "fax_number": "231-779-6264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8872 PROFESSIONAL DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018481",
            "telephone_number": "231-779-6260",
            "fax_number": "231-779-6264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "LISA",
        "middle_name": "WAITE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MI",
            "license": "5101013549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4420424",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inspire Therapy
• Timothy Matthew Iseri, MD
• John F Itnyre, M.D.
• Jacob L Brown DC PC
• Ronald Earl Jacobs Jr., D.C.
• Sheryl Alice Jenicke, D.D.S.
• Arthur Jeynes, D.P.M.
• Christin F Johnson, NP
• Eric Johnson
• Kyle Johnson, PHARM D STUDENT

• Facial Plastic Surgery Physician in Cadillac, MI
• Providers in Cadillac, MI by specialty
• Facial Plastic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.