Douglas John Jacobson, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

37008 Issued in AZ

Practice address

645 E Missouri Ave Ste 300
Phoenix, AZ 85012-1351

Phone

(602) 262-8917

Fax

(602) 262-8890

NPI assigned

Aug 10, 2007

Last updated

Jul 20, 2021By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, VI2 enrollments

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 2

Specialty

Anesthesiology

Education

University of Arizona College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeastern Anesthesia PLLCGroup PAC ID 4284813940, 83 clinicians

Hospitalist Medicine Physicians of Arizona - NogalesGroup PAC ID 9335554625, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Canyon Vista Medical Center Hospital, Sierra Vista, AZ, CCN 030043
• Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hospitalist Medicine Physicians of Arizona - Nogales

  • Certified Registered Nurse Anesthetist
  • Tucson, AZ
  • NPI 1487251799

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Northeastern Anesthesia PLLC

  • Anesthesiology Physician
  • Sierra Vista, AZ
  • NPI 1487956504
  Medicare reassignment Care Compare group NPD
• Ias Arizona PLLC

  • Anesthesiology Physician
  • Tucson, AZ
  • NPI 1689359747
  Medicare reassignment NPD
• Governor Juan F. Luis Hospital & Medical Center

  • General Acute Care Hospital
  • Christiansted, St. Croix, VI
  • NPI 1972503647
  Medicare reassignment NPD
• Valley Regional Anesthesia Associates Inc

  • Anesthesiology Physician
  • Fresno, CA
  • NPI 1578272415

  AZ

  Medicare reassignment NPD
• Governor Juan F. Luis Hospital & Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • St Croix, VI
  • NPI 1740238534
  NPD

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

• RCHP-Sierra Vista Inc

  dba Sonoita Family Health

  • Rural Health Clinic/Center
  • Sonoita, AZ
  • NPI 1013160290

  Hospital

  Care Compare affiliation
• RCHP-Sierra Vista Inc

  dba Canyon Vista Medical Center

  • General Acute Care Hospital
  • Sierra Vista, AZ
  • NPI 1194766543
  Care Compare affiliation
• RCHP-Sierra Vista Inc

  dba Tombstone Family Health

  • Rural Health Clinic/Center
  • Tombstone, AZ
  • NPI 1508010471

  Hospital

  Care Compare affiliation
• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  Care Compare affiliation

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1962694216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 E MISSOURI AVE STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121351",
            "telephone_number": "602-262-8917",
            "fax_number": "602-262-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 E MISSOURI AVE STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121351",
            "telephone_number": "602-262-8917",
            "fax_number": "602-262-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "DOUGLAS",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-10",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "37008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241517",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacobson Chiropractic PLLC
• Albert Dale Jacobson, M.D.
• Amy Michelle Jacobson, FNP
• Chaim G Jacobson, NP
• Donald Eugene Joseph Jacobson Jr.
• Julia Jacobson
• Kevin Jacobson
• Michael Andrew Jacobson, D.C.
• Michael Pescatore Jacobson, PA-C
• Traci Jacobson

• Anesthesiology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.