THOMAS E JACOBSEN MD
NPI 1053405662
Family Medicine in Hettinger, ND

Q: What is Thomas Jacobsen's NPI number?

The NPI number for Thomas Jacobsen is 1053405662. It was assigned to this individual provider in the NPPES registry on October 3, 2006.

Q: What is Thomas Jacobsen's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Thomas Jacobsen was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 03, 2006PECOS Enrolled

1000 HIGHWAY 12, HETTINGER, ND 58639(701) 567-4561 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Thomas E Jacobsen Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THOMAS E JACOBSEN MD (NPI 1053405662) is an individual family medicine provider in Hettinger, North Dakota, licensed in North Dakota (2916) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053405662

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameTHOMAS E JACOBSENCredential: MD

Location Address1000 HIGHWAY 12Hettinger, ND 58639

Mailing Address1100 Highway 12Hettinger, ND 58639-7533 · (701) 567-6130

Phone(701) 567-4561

Sole ProprietorNo

Enumeration DateOctober 3, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1053405662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in ND · 2916

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1000 HIGHWAY 12, Hettinger, ND 58639

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Other Identifiers 10

Medicare UPIND25976

Medicare ID-Type Unspecified80099100Travelers Medicare

Medicaid7774910SD

Medicaid12564ND

Medicaid3018140WA

Other10775Nd Bc/bs

Other20818Sioux Valley

Medicare ID-Type Unspecified10775

Other123993Workers Comp

Medicaid45034068812NE

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Thomas E Jacobsen Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Thomas Jacobsen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Horizon Health Care Inc

34 mi

Federally Qualified Health Center (FQHC)

105 W MAIN ST.
Bison, SD 57620

Reassigned Medicare billing, South Dakota enrollment
67 clinicians in this Medicare group

NPI 1598731648 (605) 244-5206

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58639 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $55.75 – $168.12

Typical copayment $21.42 (range $13.93 – $42.03)

Most-billed visit code 99203

Established Patient

$98.29 typical visit price

range $18.11 – $137.65

Typical copayment $24.57 (range $4.52 – $34.41)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CATHERINE E SHIREK MD

Family Medicine