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DR. JACOB H FENNESSY M.D.
NPI 1972923704
Orthopaedic Surgery - Orthopaedic Surgery of the Spine in San Diego, CA

Active since April 20, 2014PECOS EnrolledAccepts Medicare Assignment
200 W ARBOR DR, SAN DIEGO, CA 92103(800) 926-8273 Get Directions Write a Review

NPPES record last updated: February 4, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Feb 4, 2022, Jul 29, 2019 (2 updates tracked since 2019).

About Dr. Jacob H Fennessy M.d. NPPES

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

DR. JACOB H FENNESSY M.D. (NPI 1972923704) is an individual orthopaedic surgery of the spine provider in San Diego, California, licensed in California (A141175) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS, maintains a secondary practice location in Sacramento, and is a graduate of Georgetown University School Of Medicine (2014).

NPPES Registry Identity

NPI1972923704
Entity TypeIndividualMale
Primary Taxonomy207XS0117X
Provider Legal NameDR. JACOB H FENNESSYCredential: M.D.
Location Address200 W ARBOR DRSan Diego, CA 92103
Mailing AddressPo Box 232410San Diego, CA 92193-2410
Phone(800) 926-8273
Sole ProprietorYes
Medical School CMSGeorgetown University School Of MedicineGraduated 2014
Enumeration DateApril 20, 2014
Last NPPES UpdateFebruary 4, 20222 updates tracked since enumeration
✔ NPI 1972923704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Orthopaedic Surgery of the SpineAllopathic & Osteopathic Physicians
Taxonomy Code207XS0117X
License✔ Licensed in CA · A141175
Definition
Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive.
200 W ARBOR DR, San Diego, CA 92103
Open in Google Maps ↗

Secondary Practice Location 1

Location 14860 Y St, Ste 3800Sacramento, CA 95817-2307 · Phone (916) 734-2807

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

Dr. Jacob H Fennessy 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 ID9830427772
PECOS Enrollment IDI20190829003610
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 Jacob Fennessy reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Regents Of The University Of California
Same address
Orthopaedic Surgery
200 W ARBOR DR
San Diego, CA 92103
  • Reassigned Medicare billing, California enrollment
  • 93 clinicians in this Medicare group
NPI 1225130677 (800) 926-8273
Permanente Medical Group Inc
418 mi
Internal Medicine
710 LAWRENCE EXPRESSWAY
Santa Clara, CA 95051
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1073606299 (408) 851-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

DR. RAMIN MOTARJEMI M.D.
Internal Medicine (Geriatric Medicine)
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (858) 249-2500
DR. KYLE PALMER EDMONDS M.D., FAAHPM
Hospice, Inpatient
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
SHAWN RAVEENTH VEDAMANI MD
Anesthesiology
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
DALE MICHAEL TRUJILLO NP
Nurse Practitioner
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
DR. EUGENE THOMAS RICHARDSON IV MD
Internal Medicine (Infectious Disease)
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
KAYLEE PETERSEN ARNP
Nurse Practitioner (Psychiatric/Mental Health)
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
IRENE NEVAREZ NP
Nurse Practitioner
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
WILLIAM JAMES MOSS M.D.
Student in an Organized Health Care Education/Training Program
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (508) 395-4189

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 Jacob Fennessy's NPI number?

The NPI number for Jacob Fennessy is 1972923704. It was assigned to this individual provider in the NPPES registry on April 20, 2014.

Where is Jacob Fennessy located?

Jacob Fennessy practices at 200 W Arbor Dr, San Diego, CA 92103. The listed phone number is (800) 926-8273.

What is Jacob Fennessy's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Surgery of the Spine, with taxonomy code 207XS0117X.

Is Jacob Fennessy enrolled in Medicare?

Yes. Jacob Fennessy 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 Jacob Fennessy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Fennessy reassigns Medicare benefits to 2 organizations: Regents Of The University Of California (San Diego, CA) and Permanente Medical Group Inc (Santa Clara, CA). 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 Jacob Fennessy'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 Jacob Fennessy was last updated on February 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.