DR. DEREK P. JACOBSEN (NPI# 1124462593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124462593 |
| Entity Type | Individual |
| Full Name | DR. DEREK P. JACOBSEN |
| Practice Address |
18325 N Allied Way Suite 100 Phoenix AZ 85054-3105 |
| Practice Telephone | 6024674966 |
| Practice Fax Number | 4804195401 |
| Mailing Telephone | 6024674966 |
| Mailing Fax Number | 4804195401 |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2014-11-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1933 | AZ | Eye and Vision Services Providers |
| Street Address |
18325 N ALLIED WAY SUITE 100 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85054-3105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033103106 | Daniel B Feller | Ophthalmology | 18325 N Allied Way, Suite 100, Phoenix, AZ 85054-3105 | 2005-09-06 |
| 1689057085 | Robert Andrew Cook | Optometrist | 18325 N Allied Way, Suite 100, Phoenix, AZ 85054-3105 | 2015-07-02 |
| 1740682038 | Tlc Sleep Center | Durable Medical Equipment & Medical Supplies | 18325 N Allied Way, Suite 115, Phoenix, AZ 85054-3105 | 2014-09-18 |
| 1932452273 | Mrd Healthcare LLC | General Practice | 18325 N Allied Way, Suite 105, Phoenix, AZ 85054-3105 | 2012-10-24 |
| 1063645737 | Hanger Prosthetics & Orthotics West, Inc. | Durable Medical Equipment & Medical Supplies | 18325 N Allied Way, Unit 225, Phoenix, AZ 85054-3105 | 2009-08-28 |
| 1649407883 | Angela Herro Kovacik | Internal Medicine | 18325 N Allied Way, Suite 100, Phoenix, AZ 85054 | 2009-06-15 |
| 1306014345 | Sharona Optical | Eyewear Supplier (Equipment, not the service) | 18325 N Allied Way, Phoenix, AZ 85054-3105 | 2008-02-12 |
| 1144409137 | Jonathan Jay Levin | Ophthalmology | 18325 N Allied Way, Suite 100, Phoenix, AZ 85054-3105 | 2007-10-26 |
| 1962697706 | Matthew Dorchester, Dc, Ccsp, LLC | Chiropractor | 18325 N Allied Way, Suite 105, Phoenix, AZ 85054-3105 | 2007-09-13 |
| 1306931449 | Marshall Craig | Anesthesiology | 18325 N Allied Way, Suite 120, Phoenix, AZ 85054-3105 | 2006-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992255301 | Stephanie Gamber | Registered Nurse | 5405 East Pinnacle Vista Drive, Phoenix, AZ 85054 | 2016-10-10 |
| 1508231960 | Deborah Elam | Acupuncturist | 5777 East Mayo Boulevard Mayo Clinic, Phoenix, AZ 85054 | 2015-12-09 |
| 1811176860 | Desert Ridge Pediatric Dentistry | Clinic/Center | 5315 E. High Street, Suite 115, Phoenix, AZ 85054 | 2007-10-26 |
| 1902968639 | Ryan David Schulze | Chiropractor | 7000 E Mayo Blvd Ste 1058, Phoenix, AZ 85054 | 2006-12-16 |
| 1477517423 | Gary Betz II Md PC | Internal Medicine | 7010 E. Chauncey Lane, Suite 145, Phoenix, AZ 85054 | 2006-04-14 |
| 1689658395 | Alice G Mccormick | Internal Medicine | 5450 East Deer Valley Drive Unit 3206, Phoenix, AZ 85054 | 2005-12-06 |
| 1770576241 | Michelle Renee Kuhn | Physician Assistant | 6950 E Chauncey Ln, Phoenix, AZ 85054 | 2005-08-30 |
| 1609869981 | Jeffrey Alan Smith | Optometrist | 18325 N Allied Way Ste 100, Phoenix, AZ 85054 | 2005-08-23 |
| 1043219389 | Hasan Khamash | Internal Medicine | 5779 E Mayo Blvd, Phoenix, AZ 85054 | 2005-07-19 |
| 1497753750 | Rajeev Agarwal | Pediatrics | 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054 | 2005-07-11 |
| Find all providers in zip 85054 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689283830 | Kelsie Stevens | Optometrist | 6815 N 19th Ave Ste 130, Phoenix, AZ 85015-1135 | 2020-07-23 |
| 1134747801 | National Vision Inc | Optometrist | 1838 W Bell Rd, Phoenix, AZ 85023-3480 | 2020-07-09 |
| 1770109282 | Nathan Jones | Optometrist | 6135 N 35th Ave Ste 139, Phoenix, AZ 85017-1953 | 2020-06-20 |
| 1447874755 | Jenna Derubeis | Optometrist | 16515 S 40th St Ste 111, Phoenix, AZ 85048-0559 | 2020-06-02 |
| 1184250383 | Jhajaira Elizabeth Cadenas | Optometrist | 3937 W Northview Ave, Phoenix, AZ 85051 | 2020-03-19 |
| 1659927663 | National Vision Inc | Optometrist | 2805 W Agua Fria Fwy Ste 1, Phoenix, AZ 85027-3940 | 2019-08-15 |
| 1588148993 | Jillian Ralston | Optometrist | 112 W Mcdowell Road, Phoenix, AZ 85003 | 2018-09-20 |
| 1932680618 | Carefree Eyecare | Optometrist | 3170 W Carefree Hwy Ste C3c4, Phoenix, AZ 85086-3205 | 2018-08-22 |
| 1710464417 | Ngoc Le | Optometrist | 1650 E Camelback Rd Ste 160, Phoenix, AZ 85016-3947 | 2018-07-25 |
| 1255826681 | Eric Bradford Vanausdal | Optometrist | 15215 S 48th St Ste 180, Phoenix, AZ 85044-9140 | 2018-06-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.