GRANT JACOBSEN
NPI 1306647581
Radiology - Vascular & Interventional Radiology in Boise, ID

Q: What is Grant Jacobsen's NPI number?

The NPI number for Grant Jacobsen is 1306647581. It was assigned to this individual provider in the NPPES registry on March 22, 2025.

Q: What is Grant Jacobsen's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Vascular & Interventional Radiology, with taxonomy code 2085R0204X.

Q: When was this NPI record last updated?

The NPPES record for Grant Jacobsen was last updated on June 25, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 22, 2025PECOS Enrolled

500 W FORT ST # 111R, BOISE, ID 83702(208) 422-1000 Get Directions Write a Review

NPPES record last updated: June 25, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 3, 2025, Mar 22, 2025 (2 updates tracked since 2025).

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About Grant Jacobsen NPPES

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

GRANT JACOBSEN (NPI 1306647581) is an individual vascular & interventional radiology provider in Boise, Idaho, licensed in Washington (MDRE.ML.70106827) and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306647581

Entity TypeIndividualMale

Primary Taxonomy2085R0204X

Provider Legal NameGRANT JACOBSEN

Location Address500 W FORT ST # 111RBoise, ID 83702-4599

Mailing Address500 W Fort St # 111rBoise, ID 83702-4599 · (208) 422-1000

Phone(208) 422-1000

Sole ProprietorNo

Enumeration DateMarch 22, 2025

Last NPPES UpdateJune 25, 20262 updates tracked since enumeration

NPPES CertifiedJune 25, 2026

✔ NPI 1306647581 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Vascular & Interventional RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0204X

License✔ Licensed in WA · MDRE.ML.70106827

Definition

A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

Also ListedInternal MedicineTaxonomy 207R00000X · License 7271468 (ID)

500 W FORT ST # 111R, Boise, ID 83702

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Grant Jacobsen 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83702 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$65.77 typical visit price

range $16.68 – $130.93

Typical copayment $16.44 (range $4.17 – $32.73)

Most-billed visit code 99213

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

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