MRS. AMY BROZICK JACOBSON CPNP-BC
NPI 1558765636
Nurse Practitioner - Pediatrics in Reston, VA
About Mrs. Amy Brozick Jacobson Cpnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. AMY BROZICK JACOBSON CPNP-BC (NPI 1558765636) is an individual pediatrics provider in Reston, Virginia, licensed in Virginia (0024171122) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2013).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Amy Brozick Jacobson Cpnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Amy Jacobson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Vienna, VA 22180
- Reassigned Medicare billing, Virginia and District of Columbia enrollments
- Also billed through NPI 1669511051 (District of Columbia)
- 2,379 clinicians in this Medicare group
Fairfax, VA 22031
- Reassigned Medicare billing, District of Columbia and Virginia enrollments
- 128 clinicians in this Medicare group
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 20190 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
RESTON, VA 20190
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 Amy Jacobson's NPI number?
The NPI number for Amy Jacobson is 1558765636. It was assigned to this individual provider in the NPPES registry on October 17, 2014. The provider is also known as Miss Amy Joan Brozick.
Where is Amy Jacobson located?
Amy Jacobson practices at 1830 Town Center Drive Suite 205, Reston, VA 20190. The listed phone number is (703) 435-3636.
What is Amy Jacobson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.
Is Amy Jacobson enrolled in Medicare?
Yes. Amy Jacobson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Amy Jacobson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Amy Jacobson reassigns Medicare benefits to 2 organizations: Inova Health Care Services (Vienna, VA) and Pediatric Specialists Of Virginia, LLC (Fairfax, VA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Amy Jacobson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Amy Jacobson was last updated on October 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Mrs. Amy Brozick Jacobson, CPNP-BC · NPI 1558765636
Pediatrics physician in Reston, Virginia. Individual provider, active in the CMS NPPES registry since October 17, 2014.
## Identity
- **NPI:** 1558765636 (Entity type: Individual)
- **Enumerated:** October 17, 2014
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** 0024171122 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 1830 TOWN CENTER DRIVE, SUITE 205, Reston, VA 20190
- **Phone:** (703) 435-3636 · **Fax:** (703) 435-9145
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Inova Health Care Services (NPI 1275886418, Vienna, VA); Pediatric Specialists Of Virginia, LLC (NPI 1699119818, Fairfax, VA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2013
## Record status
- **NPPES last updated:** October 16, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1558765636) · Data from the CMS NPPES public registry.