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JORDAN JACOBSEN M.D.
NPI 1841646064
Emergency Medicine in Kettering, OH

Active since May 05, 2016PECOS EnrolledAccepts Medicare Assignment
3535 SOUTHERN BLVD, KETTERING, OH 45429(937) 395-8166 Get Directions Write a Review

NPPES record last updated: May 5, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 5, 2020, Jul 25, 2019, Jan 16, 2019 (3 updates tracked since 2019).

About Jordan Jacobsen M.d. NPPES

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

JORDAN JACOBSEN M.D. (NPI 1841646064) is an individual emergency medicine provider in Kettering, Ohio, licensed in Ohio (35.135028) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS, is affiliated with Miami Valley Hospital, and maintains 10 additional practice locations.

NPPES Registry Identity

NPI1841646064
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameJORDAN JACOBSENCredential: M.D.
Location Address3535 SOUTHERN BLVDKettering, OH 45429-1221
Mailing Address3131 Newmark Dr Ste 220Miamisburg, OH 45342-5400 · (937) 436-4658 · Fax (937) 436-4984
Phone(937) 395-8166
Sole ProprietorYes
Medical School CMSWright State University Boonshoft School Of MedicineGraduated 2016
Enumeration DateMay 5, 2016
Last NPPES UpdateMay 5, 20203 updates tracked since enumeration
NPPES CertifiedMay 5, 2020
✔ NPI 1841646064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in OH · 35.135028
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
3535 SOUTHERN BLVD, Kettering, OH 45429
Open in Google Maps ↗

Secondary Practice Locations 10

Location 14000 Miamisburg Centerville RdMiamisburg, OH 45342-7615 · Phone (937) 384-8791
Location 28701 Old Troy PikeHuber Heights, OH 45424-1066 · Phone (937) 558-3338
Location 3100 Kettering WayFranklin, OH 45005-1155 · Phone (937) 458-4700
Location 43535 Pentagon BlvdBeavercreek, OH 45431-1705 · Phone (937) 702-4500
Location 51141 N Monroe DrXenia, OH 45385-1619 · Phone (937) 352-2500
Location 6600 W Main StTroy, OH 45373-2928 · Phone (937) 980-7010 · Fax (937) 980-7019
Location 7450 Washington Jackson Rd Ste FEaton, OH 45320-8699 · Phone (937) 456-8376 · Fax (937) 456-8377
Location 8405 W Grand AveDayton, OH 45405-7538 · Phone (937) 723-3211 · Fax (937) 723-4609
Location 91997 Miamisburg Centerville RdCenterville, OH 45459-3811 · Phone (937) 401-6228 · Fax (937) 401-6447
Location 106147 State Route 122Middletown, OH 45005-5201 · Phone (513) 261-3410 · Fax (513) 261-3419

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

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

Jordan Jacobsen M.d. 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 ID5597058685
PECOS Enrollment IDI20190117002331
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

2

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

Phs Emergency Billing LLC
3.4 mi
Emergency Medicine
1 WYOMING ST
Dayton, OH 45409
  • Reassigned Medicare billing, Ohio enrollment
  • 143 clinicians in this Medicare group
NPI 1578387486 (937) 208-3356
Miami Valley Emergency Specialists, LLC
3.8 mi
Emergency Medicine
1 WYOMING ST
Dayton, OH 45409
  • Reassigned Medicare billing, Ohio enrollment
  • 177 clinicians in this Medicare group
NPI 1821189085 (513) 281-4400

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 4

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
290 services287 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
76 services75 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
46 services46 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
11 services11 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Miami Valley Hospital

Acute Care Hospitals · Dayton, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360051
LocationOne Wyoming StreetDayton, OH 45409 · Montgomery County
Emergency services Birthing friendly

Atrium Medical Center

Acute Care Hospitals · Franklin, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360076
LocationOne Medical Center DriveFranklin, OH 45005 · Warren County
Emergency services Birthing friendly

Upper Valley Medical Center

Acute Care Hospitals · Troy, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360174
Location3130 North County Road 25ATroy, OH 45373 · Miami County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45429 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

RAGHEED KATKHUDA MD
Pediatrics (Neonatal-Perinatal Medicine)
3535 SOUTHERN BLVD
KETTERING, OH 45429
Montgomery County (937) 752-2304
ANNEMARIE ROSE UNDERWOOD PA-C
Physician Assistant
3535 SOUTHERN BLVD
DAYTON, OH 45429
Montgomery County (937) 395-8166
SYLVIA POLENAKOVIK M.D.
Internal Medicine
3535 SOUTHERN BLVD
DAYTON, OH 45429
Montgomery County (937) 395-6665
SUSAN KAY ZANN RNFS
Registered Nurse (Registered Nurse First Assistant)
3535 SOUTHERN BLVD
KETTERING, OH 45429
Montgomery County (937) 395-8608
SWATHI DATLA M.B.B.S.
Hospitalist
3535 SOUTHERN BLVD
KETTERING, OH 45429
Montgomery County (937) 395-6665
DR. LOREN ANN NALLU MD
Pediatrics (Neonatal-Perinatal Medicine)
3535 SOUTHERN BLVD
KETTERING, OH 45429
Montgomery County (937) 752-2304
DR. JEREMY LAWTON CHAPMAN D.O.
Hospitalist
3535 SOUTHERN BLVD
KETTERING, OH 45429
Montgomery County (937) 395-6665
DR. RAHUL RAO DO
Radiology (Diagnostic Radiology)
3535 SOUTHERN BLVD
DAYTON, OH 45429
Montgomery County (937) 395-8627

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 Jordan Jacobsen's NPI number?

The NPI number for Jordan Jacobsen is 1841646064. It was assigned to this individual provider in the NPPES registry on May 5, 2016.

Where is Jordan Jacobsen located?

Jordan Jacobsen practices at 3535 Southern Blvd, Kettering, OH 45429. The listed phone number is (937) 395-8166.

What is Jordan Jacobsen's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Jordan Jacobsen enrolled in Medicare?

Yes. Jordan Jacobsen 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 Jordan Jacobsen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jordan Jacobsen reassigns Medicare benefits to 2 organizations: Phs Emergency Billing LLC (Dayton, OH) and Miami Valley Emergency Specialists, LLC (Dayton, OH). 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 Jordan Jacobsen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jordan Jacobsen accept?

Health plans from CareSource list Jordan 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.

Is Jordan Jacobsen affiliated with any hospitals?

According to CMS data, Jordan Jacobsen is affiliated with Miami Valley Hospital, Atrium Medical Center and Upper Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Jordan Jacobsen was last updated on May 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.