Alexander Dominic Jobrack, D.O, MPH
Individual provider Active NPI Aerospace Medicine Physician · Beale Afb, CA
NPI 1922488360 · NPPES record last updated Aug 29, 2022
Key facts
- NPI
- 1922488360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Aerospace Medicine Physician 2083A0100X
- License
- 1591 (NE)
- Practice address
- 15301 Warren Shingle Rd
Beale Afb, CA 95903-1905 - Phone
- (530) 634-4662
- NPI assigned
- Jun 1, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Preventive Medicine
- Education
- Arizona College of Osteopathic Medicine Mid Western University, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
301 Fisher St
5A127
Keesler Afb, MS 39534-2508
4500 Business Ctr Dr
Fairfield, CA 94534
4500 Business Ctr Dr
Fairfield, CA 94534-6888
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250902002625 | CA | Practitioner - Preventive Medicine | 8729385687 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northbay Healthcare Group | Current |
Accepting new patients | |
| Northbay Healthcare Group | Current |
Accepting new patients | |
| Northbay Health Medical Foundation | Current |
Accepting new patients | |
| Northbay Physicians Surgery Center LLC | Past | Accepting new patients |
Locations
2470 Hilborn Rd
Ste 110
Fairfield, CA 94534
Phone (707) 646-4699
2470 Hilborn Rd
Ste 100
Fairfield, CA 94534
Phone (707) 646-4600
4500 Business Center Dr
Fairfield, CA 94534
Phone (707) 646-4777
1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600
1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000
1679 E Monte Vista Ave
Ste 104
Vacaville, CA 95688
Phone (707) 624-7400
1010 Nut Tree Rd
Ste 100B
Vacaville, CA 95687
Phone (707) 646-7999
101 Main St
Winters, CA 95694
Phone (530) 795-4123
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/UMZ-Uxn6V9x08sH5gCnG-5yPg9ZX7et6/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | 1591 | NE | |
| Aerospace Medicine Physician | 2083A0100X | 1591 | NE | Yes |
Addresses
Primary practice location
15301 Warren Shingle Rd
Beale Afb, CA 95903-1905
Mailing address
15301 Warren Shingle Rd
Beale Afb, CA 95903-1905
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | alexander.d.jobrack.mil@health.mil | Direct |
Other providers in Beale Afb, CA
- Kimberly M Higgins
- Charlie Holt
- Kevin Ray Hooker
- Melodee Jackson
- Diane M Janssen
- Melissa G Johnson
- Leonid M. Katkovsky
- Shalaleh Khoei
- Jaehong Kim
- Wanetta King
All providers in Beale Afb, CA · Aerospace Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.