BRUCE KENNETH JACOBSON PH.D., P.C.
NPI 1679743009
Psychologist in Salt Lake City, UT

Active since February 29, 2008PECOS EnrolledAccepts Medicare Assignment
4190 HIGHLAND DR, SUITE 211, SALT LAKE CITY, UT 84124(801) 272-0614 Get Directions Write a Review

NPPES record last updated: March 14, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Bruce Kenneth Jacobson Ph.d., P.c. NPPES

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

BRUCE KENNETH JACOBSON PH.D., P.C. (NPI 1679743009) is an individual psychologist in Salt Lake City, Utah, licensed in Utah (450510082) and active in the NPI registry since February 2008. He is enrolled in Medicare PECOS and is a graduate of Other (1989).

NPPES Registry Identity

NPI1679743009
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameBRUCE KENNETH JACOBSONCredential: PH.D., P.C.
Location Address4190 HIGHLAND DR, SUITE 211Salt Lake City, UT 84124-2600
Mailing Address4190 Highland Dr, Suite 211Salt Lake City, UT 84124-2600 · (801) 272-0614
Sole ProprietorYes
Medical School CMSOtherGraduated 1989
Enumeration DateFebruary 29, 2008
Last NPPES UpdateMarch 14, 2018
NPI 1679743009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in UT · 450510082
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

4190 HIGHLAND DR, Salt Lake City, UT 84124

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Bruce Kenneth Jacobson Ph.d., P.c. 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 ID6608841481
PECOS Enrollment IDI20040826000954
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.

Other Providers at the Same Location NPPES 10

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

Social Worker (Clinical)
4190 HIGHLAND DR, SUITE 210
SALT LAKE CITY, UT 84124
Pharmacist
4190 HIGHLAND DR, SUITE 250
SALT LAKE CITY, UT 84124
Clinic/Center (Adult Mental Health)
4190 HIGHLAND DR, SUITE 211
SALT LAKE CITY, UT 84124
Dentist (Oral and Maxillofacial Surgery)
4190 HIGHLAND DR, SUITE 112
SALT LAKE CITY, UT 84124
Counselor (Professional)
4190 HIGHLAND DR, SUITE 211
SALT LAKE CITY, UT 84124
Social Worker (Clinical)
4190 HIGHLAND DR, SUITE 210
SALT LAKE CITY, UT 84124
Psychologist (Clinical)
4190 HIGHLAND DR
SALT LAKE CITY, UT 84124
Psychologist
4190 HIGHLAND DR, SUITE 210
SALT LAKE CITY, UT 84124

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 Bruce Jacobson's NPI number?

The NPI number for Bruce Jacobson is 1679743009. It was assigned to this individual provider in the NPPES registry on February 29, 2008.

Where is Bruce Jacobson located?

Bruce Jacobson practices at 4190 Highland Dr Suite 211, Salt Lake City, UT 84124. The listed phone number is (801) 272-0614.

What is Bruce Jacobson's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Bruce Jacobson enrolled in Medicare?

Yes. Bruce 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.

What insurance does Bruce Jacobson accept?

Health plans from Molina Healthcare and University of Utah Health Plans list Bruce Jacobson 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 Bruce Jacobson was last updated on March 14, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.