Dr Randolph J Jacobs, MD is a medicare enrolled "Dermatology" physician in Wildomar, California. He graduated from medical school in 1986 and has 39 years of diverse experience with area of expertise as Dermatology. His current practice location is
23905 Clinton Keith Rd Ste 114, Wildomar, California. You can reach out to his office (for appointments etc.) via phone at
(951) 672-7673.
Dr Randolph J Jacobs is licensed to practice in California (license number G61654) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1417975905.
Physician's Profile
| Full Name | Dr Randolph J Jacobs |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 39 Years |
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| Location | 23905 Clinton Keith Rd Ste 114, Wildomar, California |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Randolph J Jacobs graduated from medical school in 1986
NPI Data:
- NPI Number: 1417975905
- Provider Enumeration Date: 07/17/2006
- Last Update Date: 03/12/2008
Medicare PECOS Information:
- PECOS PAC ID: 3072696533
- Enrollment ID: I20080515000667
Medical Identifiers
Medical identifiers for Dr Randolph J Jacobs such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1417975905 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | G61654 (California) | Primary |
| 207NI0002X | Dermatology - Clinical & Laboratory Dermatological Immunology | G61654 (California) | Secondary |
| 207ND0900X | Dermatology - Dermatopathology | G61654 (California) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | G61654 (California) | Secondary |
| 207NP0225X | Dermatology - Pediatric Dermatology | G61654 (California) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Randolph J Jacobs allows following entities to bill medicare on his behalf.
| Entity Name | Randy Jacobs Dermatology Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1699872630
PECOS PAC ID: 8123101680
Enrollment ID: O20080207000367 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Randolph J Jacobs is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Randolph J Jacobs, MD
23905 Clinton Keith Rd Ste 114,
Wildomar, CA 92595-7899
Ph: (951) 672-7673 | Dr Randolph J Jacobs, MD
23905 Clinton Keith Rd Ste 114,
Wildomar, CA 92595-7899
Ph: (951) 672-7673 |
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