Kyle M Jakubowski

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0034690 Issued in OH

Practice address

2109 Hughes Dr # 450
Toledo, OH 43606-3858

Phone

(419) 291-2003

Fax

(419) 479-6977

NPI assigned

Oct 2, 2023

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 MI, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

University of Toledo College of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promedica Multi Specialty PhysiciansGroup PAC ID 7113182809, 269 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
• Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005
• Promedica Monroe Regional Hospital Hospital, Monroe, MI, CCN 230099
• Memorial Hospital Hospital, Fremont, OH, CCN 360156
• Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjakubowski51791@direct.promedica.org

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.

• Promedica Multi Specialty Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1306105150

  MI

  Medicare reassignment Care Compare group NPD

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

• Bay Park Community Hospital

  • General Acute Care Hospital
  • Oregon, OH
  • NPI 1598765539
  Care Compare affiliation
• Memorial Hospital

  • General Acute Care Hospital
  • Fremont, OH
  • NPI 1851338149
  Care Compare affiliation
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Care Compare affiliation
• Toledo Hospital

  dba ProMedica Transportation Network

  • Ambulance
  • Toledo, OH
  • NPI 1427147339

  Hospital

  Care Compare affiliation
• Emma L. Bixby Medical Center

  • General Acute Care Hospital
  • Adrian, MI
  • NPI 1972564730
  Care Compare affiliation
• Mercy Memorial Hospital Corporatio

  dba Promedica Monroe Regional Hospital

  • General Acute Care Hospital
  • Monroe, MI
  • NPI 1811097223
  Care Compare affiliation
• Mercy Memorial Hospital Corporation

  dba Monroe Cancer Center

  • Specialist
  • Monroe, MI
  • NPI 1376997551

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1942080585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 N HOLLAND SYLVANIA RD APT 3308",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233551",
            "telephone_number": "419-508-9869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 HUGHES DR # 450",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063858",
            "telephone_number": "419-291-2003",
            "fax_number": "419-479-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKUBOWSKI",
        "first_name": "KYLE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-02",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0034690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Toledo, OH
• Providers in Toledo, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.