JESSE JACOBS (NPI# 1457779555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457779555 |
| Entity Type | Individual |
| Full Name | JESSE JACOBS |
| Practice Address |
435 Phalen Blvd Saint Paul MN 55130-5302 |
| Mailing Address |
8170 33rd Ave S Bloomington MN 55425-4516 |
| Practice Telephone | 6512548500 |
| Mailing Telephone | 6512548500 |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2020-07-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 67498 | MN | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 201901598 | NC | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114356466 | Jesse Jacobs | Chiropractor | 4525 Heritage Trace Pkwy, Suite 101, Fort Worth, TX 76244-8908 | 2013-11-07 |
| 1003061532 | Jesse Jacobs | Physician Assistant | 401 E Carrillo St, Santa Barbara, CA 93101-1460 | 2008-11-25 |
| Street Address |
435 PHALEN BLVD |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55130-5302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740720812 | Nicole Renee Hoisser | Nurse Practitioner | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2017-03-08 |
| 1922548809 | Amy Jo Porter | Specialist | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2017-02-27 |
| 1285186619 | Katherine Jonas | Physician Assistant | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-11-02 |
| 1316491970 | Angela Kezar | Occupational Therapist | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-08-11 |
| 1760833446 | Marie-pier Winters | Physical Therapist | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-06-24 |
| 1376904698 | Michaelen Elise Sundstrom | Physical Therapist | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-03-14 |
| 1932568524 | Lindsay Knight | Specialist/Technologist | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-02-11 |
| 1134594310 | Dawn Babcock | Nurse Practitioner | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2015-12-14 |
| 1750767158 | Leonardo E Candelario Perez | Psychologist | 435 Phalen Blvd, Saint Paul, MN 55130 | 2015-08-07 |
| 1487030490 | Clinton Mccullough | Specialist/Technologist | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2015-08-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904587 | Confident Care LLC | In Home Supportive Care | 1040 Arkwright Street, Saint Paul, MN 55130 | 2018-09-01 |
| 1881015253 | Lucas Bosco Wanga | Psychologist | 715 Edgerton Street, Merrick Community Services, St. Paul, MN 55130 | 2014-01-02 |
| 1174865570 | Sarang Patel | Internal Medicine | 401 Phalen Blvd # 41103d, Saint Paul, MN 55130 | 2013-03-23 |
| 1427394501 | Zongxee Lee | Registered Nurse | 1072 Payne Ave, St. Paul, MN 55130 | 2012-12-18 |
| 1740532753 | One Stop Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 1049 Payne Ave Suite C, St Paul, MN 55130 | 2012-10-15 |
| 1689923997 | Alexis Simmons | Counselor | 402 University Ave East, Suite A-127, Saint Paul, MN 55130 | 2012-08-31 |
| 1689804064 | Group Health Plan, Inc. | Durable Medical Equipment & Medical Supplies | 537 Phalen Blvd, Saint Paul, MN 55130 | 2009-07-21 |
| 1477756534 | Chad Everett Christensen | Chiropractor | 1073 Payne Ave, Saint Paul, MN 55130 | 2007-06-07 |
| 1922219021 | Qwik Urgent Care Clinic | Family Medicine | 1239 Payne Avenue, Saint Paul, MN 55130 | 2007-05-24 |
| 1275743981 | Yia Vang | Technician | 1100 Arkwright St., St. Paul, MN 55130 | 2007-05-23 |
| Find all providers in zip 55130 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205823440 | Walter Paul Gleich | Urology | 360 Sherman St, Suite 450, Saint Paul, MN 55102-2564 | 2005-10-03 |
| 1972915346 | Colby Adams Dixon | Urology | 435 Phalen Blvd, Mail Stop 51103c, Saint Paul, MN 55130-5302 | 2014-05-20 |
| 1659695310 | Garjae Dayan Lavien | Urology | 435 Phalen Blvd, Mail Stop 51103c, Saint Paul, MN 55130 | 2010-03-23 |
| 1043403363 | Joshua Lane Woelk | Urology | 205 Wabasha St S, Saint Paul, MN 55107-1805 | 2007-08-21 |
| 1033107404 | Michael Howard Wipf | Urology | 360 Sherman St, Suite 400, Saint Paul, MN 55102-2564 | 2005-10-11 |
| 1205823200 | Michael Lee Pergament | Urology | 360 Sherman St, Suite 400, Saint Paul, MN 55102-2564 | 2005-10-04 |
| 1881681815 | Andrew John Portis | Urology | 360 Sherman St, Suite 400, Saint Paul, MN 55102-2564 | 2005-10-04 |
| 1104813138 | Peter Donald Sershon | Urology | 360 Sherman St, Suite 450, Saint Paul, MN 55102-2564 | 2005-10-04 |
| 1245227453 | Robert David Fisher | Urology | 360 Sherman St, Suite 450, Saint Paul, MN 55102-2564 | 2005-10-03 |
| 1467449678 | Cesar Juan Jose Ercole | Urology | 360 Sherman St, Suite 450, Saint Paul, MN 55102-2564 | 2005-10-03 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55130 |
Please comment or provide details below to improve the information on JESSE JACOBS.
| 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.