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DR. MATTHEW JACOBSEN DMD, MD
NPI 1568453108
Dentist - Oral and Maxillofacial Surgery in South Portland, ME

Active since November 02, 2005Opted out of Medicare · through Sep 1, 2027
20 LONG CREEK DR, SOUTH PORTLAND, ME 04106(207) 772-3027(207) 772-8641 Get Directions Write a Review

NPPES record last updated: July 2, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Matthew Jacobsen Dmd, Md NPPES

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

DR. MATTHEW JACOBSEN DMD, MD (NPI 1568453108) is an individual oral and maxillofacial surgery provider in South Portland, Maine, licensed in Maine (4167) and active in the NPI registry since November 2005. He has opted out of Medicare through September 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1568453108
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. MATTHEW JACOBSENCredential: DMD, MD
Location Address20 LONG CREEK DRSouth Portland, ME 04106-2425
Mailing Address20 Long Creek Drive, Oral Surgery Associates PaSouth Portland, ME 04106 · (207) 772-3027 · Fax (207) 772-8641
Phone(207) 772-3027
Fax(207) 772-8641
Sole ProprietorNo
Enumeration DateNovember 2, 2005
Last NPPES UpdateJuly 2, 2015
✔ NPI 1568453108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in ME · 4167
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
20 LONG CREEK DR, South Portland, ME 04106
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Dr. Matthew Jacobsen Dmd, Md 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 September 1, 2013 through September 1, 2027.

Opt-Out Effective DateSeptember 1, 2013
Opt-Out In Effect ThroughSeptember 1, 2027Opt-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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04106 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
$86.72 typical visit price
range $56.28 – $169.96
Typical copayment $21.68 (range $14.07 – $42.49)
Most-billed visit code 99203
Established Patient
$70.13 typical visit price
range $18.22 – $138.92
Typical copayment $17.53 (range $4.55 – $34.73)
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.

Other Providers at the Same Location NPPES 4

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

DR. KILLIAN DAVID MACCARTHY DMD MD
Dentist (Oral and Maxillofacial Surgery)
20 LONG CREEK DR, ORAL SURGERY ASSOCIATES PA
SOUTH PORTLAND, ME 04106
Cumberland County (207) 772-3027
MARK D ZAJKOWSKI DDS,MD
Dentist (Oral and Maxillofacial Surgery)
20 LONG CREEK DR, SUITE B
SOUTH PORTLAND, ME 04106
Cumberland County (207) 772-4063
ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PA
Dentist (Oral and Maxillofacial Surgery)
20 LONG CREEK DR
SOUTH PORTLAND, ME 04106
Cumberland County (207) 772-4063
DAVID J MOYER DDS,MD
Dentist (Oral and Maxillofacial Surgery)
20 LONG CREEK DR, SUITE B
SOUTH PORTLAND, ME 04106
Cumberland County (207) 772-4063

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 Matthew Jacobsen's NPI number?

The NPI number for Matthew Jacobsen is 1568453108. It was assigned to this individual provider in the NPPES registry on November 2, 2005.

Where is Matthew Jacobsen located?

Matthew Jacobsen practices at 20 Long Creek Dr, South Portland, ME 04106. The listed phone number is (207) 772-3027.

What is Matthew Jacobsen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Matthew Jacobsen enrolled in Medicare?

No. Matthew Jacobsen has opted out of Medicare through September 1, 2027. 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.

What insurance does Matthew Jacobsen accept?

Health plans from Anthem Blue Cross and Blue Shield list Matthew Jacobsen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Matthew Jacobsen was last updated on July 2, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.