ANDRE JACK JACOBSEN
NPI 1629574223
Anesthesiology in Anchorage, AK

Q: What is Andre Jacobsen's NPI number?

The NPI number for Andre Jacobsen is 1629574223. It was assigned to this individual provider in the NPPES registry on April 3, 2018.

Q: What is Andre Jacobsen's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Q: When was this NPI record last updated?

The NPPES record for Andre Jacobsen was last updated on September 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 April 03, 2018PECOS EnrolledAccepts Medicare Assignment

3300 PROVIDENCE DR STE 205, ANCHORAGE, AK 99508(907) 561-1510 Get Directions Write a Review

NPPES record last updated: September 7, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Andre Jack Jacobsen NPPES

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

ANDRE JACK JACOBSEN (NPI 1629574223) is an individual anesthesiology provider in Anchorage, Alaska, licensed in Alaska (200882) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS and is a graduate of Medical College Of Wisconsin (2018).

NPPES Registry Identity

NPI1629574223

Entity TypeIndividualMale

Primary Taxonomy207L00000X

Provider Legal NameANDRE JACK JACOBSEN

Location Address3300 PROVIDENCE DR STE 205Anchorage, AK 99508-4620

Mailing Address3300 Providence Dr Ste 205Anchorage, AK 99508-4620 · (907) 561-1510

Phone(907) 561-1510

Sole ProprietorNo

Medical School CMSMedical College Of WisconsinGraduated 2018

Enumeration DateApril 3, 2018

Last NPPES UpdateSeptember 7, 2023

NPPES CertifiedSeptember 7, 2023

✔ NPI 1629574223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians

Taxonomy Code207L00000X

License✔ Licensed in AK · 200882

Definition

An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.

3300 PROVIDENCE DR STE 205, Anchorage, AK 99508

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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

Andre Jack Jacobsen 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.

PECOS PAC ID3476907924

PECOS Enrollment IDI20231002002961

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 Reassignment

Medicare enrollment records show Andre Jacobsen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Providence Anchorage Anesthesia Medical Group, P.C.

Same address

Anesthesiology

3300 PROVIDENCE DR, SUITE 207
Anchorage, AK 99508

Reassigned Medicare billing, Alaska enrollment
Medicare enrollment name: Providence Anchorage Anesthesia Medical Group PC
90 clinicians in this Medicare group

NPI 1659368397 (907) 561-0005

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 10

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.

Insertion of artery tube for blood sampling or infusion through skin 36620

This procedure involves placing a small tube into an artery, usually in the wrist or elbow, to collect blood samples or administer medication. It's done under local anesthesia and is a common, safe practice.

60 services59 patients

Anesthesia for procedure on heart and large blood vessels 00560

Anesthesia for heart and large blood vessel procedures involves using medications to block sensation, ensuring you don't feel pain during surgery. It can be general (you're asleep) or regional (part of your body is numbed). It helps ensure comfort and safety throughout the operation.

39 services39 patients

Ultrasound of heart with probe in esophagus, with report 93312

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

28 services28 patients

Insertion of non-tunneled central venous tube for infusion (5 years or older) 36556

This procedure involves placing a thin tube into a large vein, usually in the neck or chest, to administer medication or fluids. It's done under local anesthesia to minimize discomfort. It's a standard, safe procedure for individuals aged 5 and above.

22 services22 patients

Anesthesia for x-ray or radiation therapy 01922

Anesthesia for x-ray or radiation therapy involves administering medication to help you relax or sleep during the procedure. It's used to ensure comfort, minimize movement, and reduce anxiety. The type of anesthesia used depends on the procedure and patient's health.

17 services17 patients

Anesthesia for procedure to assess heart electrical activity 00537

Anesthesia for a procedure to assess heart electrical activity helps ensure comfort and relaxation. It involves administering medication that either numbs a specific area or makes you sleep temporarily. This allows doctors to safely examine your heart's electrical signals without causing discomfort.

16 services16 patients

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.

THOMAS WEISSMUELLER MD

Anesthesiology (Pediatric Anesthesiology)