Jacob Ryan Stewart, MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

12745059-1205 Issued in UT

Practice address

2245 N 400 E Ste 104
North Logan, UT 84341-1785

Phone

(435) 752-5741

NPI assigned

Apr 6, 2018

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 UT

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 1

Specialty

Dermatology

Education

University of Texas Southwestern Medical School at Dallas, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kelly W Hubbard MD PCGroup PAC ID 1951499433, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.47 of 100Reported as individual

Quality

86.67

Promoting interoperability

96

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jstewart600381@ehrdirect.mayoclinicmsg.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.

• Kelly W Hubbard MD PC

  • Dermatology Physician
  • Logan, UT
  • NPI 1770779985
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1962909937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 N 400 E STE 104",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843411785",
            "telephone_number": "608-785-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 N 400 E STE 104",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843411785",
            "telephone_number": "435-752-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JACOB",
        "middle_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-06",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "UT",
            "license": "12745059-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rex Alan Spendlove, LPC
• Spine and Muscular Rehabilitation Chiropractic PLLC
• Jeremy C Starr, DO
• Stevens Chiropractic PC
• Evan Stewart, LMFT
• Team Recovery
• Brady Michael Thomson, DDS
• Ian Michael Troesoyer, FNP-C
• University of Utah Cache Valley Emergency Medicine
• Valley Obstetrics and Gynecology, PC

• MOHS-Micrographic Surgery Physician in North Logan, UT
• Providers in North Logan, UT by specialty
• MOHS-Micrographic Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; 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.