MR. CHAD LAWRENCE JACOBS PMHNP
NPI 1336783893
Nurse Practitioner - Psychiatric/Mental Health in Mountlake Terrace, WA

Q: What is Chad Jacobs's NPI number?

The NPI number for Chad Jacobs is 1336783893. It was assigned to this individual provider in the NPPES registry on October 29, 2019.

Q: What is Chad Jacobs's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Chad Jacobs was last updated on November 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 29, 2019PECOS Enrolled

21907 64TH AVE W STE 200, MOUNTLAKE TERRACE, WA 98043(317) 695-8041 Get Directions Write a Review

NPPES record last updated: November 15, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 15, 2021, Feb 27, 2020, Oct 29, 2019 (3 updates tracked since 2019).

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About Mr. Chad Lawrence Jacobs Pmhnp NPPES

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

MR. CHAD LAWRENCE JACOBS PMHNP (NPI 1336783893) is an individual psychiatric/mental health provider in Mountlake Terrace, Washington, licensed in Washington (AP61025855) and active in the NPI registry since October 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336783893

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameMR. CHAD LAWRENCE JACOBSCredential: PMHNP

Location Address21907 64TH AVE W STE 200Mountlake Terrace, WA 98043-6200

Mailing Address2619 Baker Ave Apt 1Everett, WA 98201-3161 · (317) 695-8041

Phone(317) 695-8041

Sole ProprietorNo

Enumeration DateOctober 29, 2019

Last NPPES UpdateNovember 15, 20213 updates tracked since enumeration

NPPES CertifiedNovember 15, 2021

✔ NPI 1336783893 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Licenses✔ Licensed in WA · AP61025855✔ Licensed in FL · 11004760

21907 64TH AVE W STE 200, Mountlake Terrace, WA 98043

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna HealthCare of Arizona, Inc.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Chad Lawrence Jacobs Pmhnp 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 Reassignments

Medicare enrollment records show Chad Jacobs reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mindful Therapy Group PC

0.3 mi

Clinical

6505 216TH ST SW STE 100
Mountlake Terrace, WA 98043

Reassigned Medicare billing, Washington enrollment
777 clinicians in this Medicare group

NPI 1316238678 (425) 640-7009

Connect Mental Health And Wellness, LLC

1,107 mi

Psychiatric/Mental Health

12301 W BELL RD STE A102
Surprise, AZ 85378

Reassigned Medicare billing, Arizona enrollment

NPI 1922785567 (407) 473-1137

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

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

53 services12 patients

Psychotherapy with evaluation and management visit, 30 minutes 90833

Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.

47 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98043 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

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

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.

PAULETTE M CASWELL LICSW

Social Worker (Clinical)