NPIMap

Individual provider Active NPI

Marilyn Elizabeth Jacobs, M.D.

  • Internal Medicine Physician
  • Wichita, KS
National Provider Identifier
1952523698
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04-32354 Issued in KS
Practice address
105 S Broadway St
Suite 730
Wichita, KS 67202-4227
Phone
(316) 393-9933
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 04-32354 KS Primary

Addresses

Primary practice location

105 S Broadway St
Suite 730
Wichita, KS 67202-4227

Mailing address

105 S Broadway St
Suite 730
Wichita, KS 67202-4227
Phone (316) 393-9933

Other identifiers 1

IdentifierTypeStateIssuer
200426290AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070614000352 KS Practitioner - Internal Medicine 4688772627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Nebraska College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2770 N Webb Rd
Wichita, KS 67226-8112
Phone (316) 630-4230

3333 N Webb Rd
Wichita, KS 67226-8123
Phone (316) 462-5000

3601 N Webb Rd
Wichita, KS 67226-8129
Phone (316) 630-5000

550 N Hillside
Wesley Medical Center
Wichita, KS 67214-4910
Phone (316) 962-2000

9100 W 14TH St
Shawnee Mission, KS 66204-4004
Phone (913) 676-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as apm
Quality
77.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-32354KSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Kansas PA Internal Medicine CurrentSince May 28, 2014 Accepting new patients
Inpatient Consultants of Kansas PA Internal Medicine CurrentSince May 28, 2014 Accepting new patients
Ascension Via Christi Rehabilitation Hospital, Inc. Past Accepting new patients

Locations

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

1131 S Clifton Ave
Ste B
Wichita, KS 67218
Phone (316) 462-1040

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20807/brand/4/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1952523698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S BROADWAY ST",
            "address_2": "SUITE 730",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672024227",
            "telephone_number": "316-393-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S BROADWAY ST",
            "address_2": "SUITE 730",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672024227",
            "telephone_number": "316-393-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "MARILYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-32354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200426290A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.