Michael Jacobson (NPI# 1649352964, PAC ID# 2365517893) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1649352964 |
| PAC ID by PECOS | 2365517893 |
| Professional Enrollment ID | I20110902000423 |
| Full Name | Michael Jacobson |
| Organization Legal Name | BB MEDICAL AND DERMATOLOGY INC |
| Address |
368 Broadway Suite 103 104 Kingston NY 12401-5144 |
| Phone Number | 8453387472 |
| Gender | M |
| Medical School | JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY |
| Graduation Year | 2004 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 8123396447 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 070006 | STAMFORD HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 25 Tamarack Ave, Danbury, CT 06811-4829 | 2037978990 | ADVANCED DERMCARE PC |
| 368 Broadway, Suite 103 104, Kingston, NY 12401-5144 | 8453387472 | BB MEDICAL AND DERMATOLOGY INC |
| 13 Park St, Norwalk, CT 06851-4811 | 2038472400 | SKIN CARE PHYSICIANS OF FAIRFIELD COUNTY, LLC |
| 1051 Long Ridge Rd, Stamford, CT 06903-4436 | 2033297960 | LONG RIDGE DERMATOLOGY,LLC |
| 2890 Main St C, Stratford, CT 06614-4980 | 2033758200104 | SKIN CARE PHYSICIANS OF FAIRFIELD COUNTY, LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% |
| Organization Legal Name | BB MEDICAL AND DERMATOLOGY INC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brooke N Bair | Dermatology | Bb Medical and Dermatology Inc | 368 Broadway, Suite 103 104, Kingston, NY 12401-5144 |
| Abigail Brenkach | Physician Assistant | Bb Medical and Dermatology Inc | 368 Broadway, Suite 103 104, Kingston, NY 12401-5144 |
| Street Address |
368 BROADWAY SUITE 103 104 |
| City | KINGSTON |
| State | NY |
| Zip | 12401-5144 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brooke N Bair | Dermatology | Bb Medical and Dermatology Inc | 368 Broadway, Suite 103 104, Kingston, NY 12401-5144 |
| Faisal Waheed | Hematology/oncology | 368 Broadway, Suite 403, Kingston, NY 12401-5160 | |
| Somsak Bhitiyakul | Internal Medicine | 368 Broadway, Suite 201, Kingston, NY 12401-5160 | |
| Abigail Brenkach | Physician Assistant | Bb Medical and Dermatology Inc | 368 Broadway, Suite 103 104, Kingston, NY 12401-5144 |
| Govind Pralash Chaturvedi | Otolaryngology | 368 Broadway, Suite 102, Kingston, NY 12401-5158 | |
| Marie Louise T Johnson | Dermatology | Dermatology Services of Kingston PC | 368 Broadway, Suite 105, Kingston, NY 12401-5160 |
| Thomas G Triplett | Dermatology | Dermatology Services of Kingston PC | 368 Broadway, Suite 105, Kingston, NY 12401-5160 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jonathan Paul Sumber | Podiatry | 190 Fair St, Kingston, NY 12401-0514 | |
| Shany David | Neurology | Health Quest Medical Practice, PC | 150 Sawkill Rd, Kingston, NY 12401-1208 |
| Anthony A Blisko | Chiropractic | 134 Sawkill Rd, Kingston, NY 12401-1208 | |
| Stefan T Rau | Diagnostic Radiology | Health Quest Medical Practice, PC | 150 Sawkill Rd, Kingston, NY 12401-1208 |
| Janet N Tamai | Neurology | Health Quest Medical Practice, PC | 150 Sawkill Rd, Kingston, NY 12401-1208 |
| Danielle S Williams | Diagnostic Radiology | Health Quest Medical Practice, PC | 150 Sawkill Rd, Kingston, NY 12401-1208 |
| Timothy Shepard | Diagnostic Radiology | Health Quest Medical Practice, PC | 150 Sawkill Rd, Kingston, NY 12401-1208 |
| John A Mastrangelo | Diagnostic Radiology | Health Quest Medical Practice, PC | 150 Sawkill Rd, Kingston, NY 12401-1208 |
| Anita K Goodrich | Family Medicine | Health Quest Medical Practice, PC | 150 Sawkill Rd, Kingston, NY 12401-1208 |
| Gerald M Kufner | Neurology | Health Quest Medical Practice, PC | 150 Sawkill Rd, Kingston, NY 12401-1208 |
| Find all physicians in zip 12401 | |||
| City | KINGSTON |
| Zip Code | 12401 |
| Specialty | DERMATOLOGY |
| City + Specialty | KINGSTON + DERMATOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.