Alice M Jacobson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PT852 Issued in WY

Practice address

214 E 23Rd St
Cheyenne, WY 82001-3748

Phone

(307) 634-2273

NPI assigned

Dec 17, 2019

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

Medicare fee-for-service enrollment

Enrolled in WY, TX, CO, WA4 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 4

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carepoint Emergency Medicine, PLLCGroup PAC ID 7810291432, 160 clinicians

Tacoma Emergency Care Physicians PLLCGroup PAC ID 5294971800, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

Merit-based Incentive Payment System (MIPS)

Final score

68.47 of 100Reported as group

Quality

53.04

Promoting interoperability

81

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Carepoint Emergency Medicine, PLLC

  • Emergency Medicine Physician
  • Denver, CO
  • NPI 1134590318
  Medicare reassignment Care Compare group
• Tacoma Emergency Care Physicians, PLLC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1770823791
  Medicare reassignment Care Compare group
• Ivinson Memorial Hospital

  • Rural Health Clinic/Center
  • Laramie, WY
  • NPI 1033628599

  Single Specialty

  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  Single Specialty, TX

  Medicare reassignment NPD
• Summit Medical Group, LLC

  • Emergency Medicine Physician
  • Cheyenne, WY
  • NPI 1457802993
  Medicare reassignment
• Ivinson Memorial Hospital

  • Rural Acute Care Hospital
  • Laramie, WY
  • NPI 1366626269
  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Martin, SD
  • NPI 1003208257

  Single Specialty

  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518

  Single Specialty

  NPD
• Tacoma Emergency Care Physicians, PLLC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1073854766

  Single Specialty

  NPD
• Tacoma Emergency Care Physicians, PLLC

  • Emergency Medicine Physician
  • Covington, WA
  • NPI 1295075216

  Single Specialty

  NPD

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

• Multicare Health System

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1366556227
  Care Compare affiliation

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1952949240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E 18TH ST APT 2",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 E 23RD ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013748",
            "telephone_number": "307-634-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ALICE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "PT852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey S Jacks, COTA
• David Jackson Jr.
• Heather Vance Jackson, M.S.W.
• Katelynn Jackson
• Alec Jay Jacobs, DPT
• Sarah Christine Jacobson, RN
• Stephen G. Jacobson, MD
• Paul J Jacquay, PA-C
• Nevaeh Jacques
• Raja Shekar Rao Jadav, MD

• Physician Assistant in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.