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DR. EDWARD JACOBSON M.D.
NPI 1336208651
Specialist in Greenwich, CT

Active since December 06, 2006Opted out of Medicare · through Mar 1, 2028
1 PERRYRIDGE RD, GREENWICH, CT 06830(203) 869-8353(203) 869-4004 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Edward Jacobson M.d. NPPES

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

DR. EDWARD JACOBSON M.D. (NPI 1336208651) is an individual specialist in Greenwich, Connecticut, licensed in Connecticut (22707) and active in the NPI registry since December 2006. He has opted out of Medicare through March 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1336208651
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. EDWARD JACOBSONCredential: M.D.
Location Address1 PERRYRIDGE RDGreenwich, CT 06830-4607
Mailing Address1 Perryridge RdGreenwich, CT 06830-4607 · (203) 869-8353 · Fax (203) 869-4004
Phone(203) 869-8353
Fax(203) 869-4004
Sole ProprietorYes
Enumeration DateDecember 6, 2006
Last NPPES UpdateJuly 9, 2007
✔ NPI 1336208651 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CT · 22707
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1 PERRYRIDGE RD, Greenwich, CT 06830
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Other Identifiers 2

Other010022707CT02CT · Blue Cross Provider Numbe
Medicare UPINDO2586CT

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Edward Jacobson M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 1, 2014 through March 1, 2028.

Opt-Out Effective DateMarch 1, 2014
Opt-Out In Effect ThroughMarch 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 5

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

RICHARD C CONNORS MD PC
Dermatology
1 PERRYRIDGE RD, SUITE 2
GREENWICH, CT 06830
Western Connecticut Planning Region (203) 622-0808
DONNA J HAGBERG, MD., LLC
Specialist
1 PERRYRIDGE RD
GREENWICH, CT 06830
Western Connecticut Planning Region (203) 869-8353
LVRI
Obstetrics & Gynecology (Gynecology)
1 PERRYRIDGE RD
GREENWICH, CT 06830
Western Connecticut Planning Region (203) 869-8360
DR. RICHARD CHARLES CONNORS M.D.
Dermatology
1 PERRYRIDGE RD, SUITE 2
GREENWICH, CT 06830
Western Connecticut Planning Region (203) 622-0808
GREENWICH GYNECOLOGY LLC
Obstetrics & Gynecology (Gynecology)
1 PERRYRIDGE RD
GREENWICH, CT 06830
Western Connecticut Planning Region (203) 869-8353

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edward Jacobson's NPI number?

The NPI number for Edward Jacobson is 1336208651. It was assigned to this individual provider in the NPPES registry on December 6, 2006.

Where is Edward Jacobson located?

Edward Jacobson practices at 1 Perryridge Rd, Greenwich, CT 06830. The listed phone number is (203) 869-8353.

What is Edward Jacobson's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Edward Jacobson enrolled in Medicare?

No. Edward Jacobson has opted out of Medicare through March 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Edward Jacobson was last updated on July 9, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.