Grant Jacobsen
NPI 1306647581ActiveIndividual· Radiology, Vascular & Interventional Radiology· Boise, ID
Radiology, Vascular & Interventional Radiology in Boise, Idaho, licensed in WA and ID, with an NPI issued in March 2025. Enrolled in Medicare as order and referring only - internal medicine.
Overview
| NPI | 1306647581 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Mar 22, 2025 |
| Last updated in NPPES | Jun 25, 2026 |
| Certified by provider | Jun 25, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Radiology, Vascular & Interventional Radiology Primary | 2085R0204X | MDRE.ML.70106827 | WA |
| Internal Medicine | 207R00000X | 7271468 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Internal Medicine (ID) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other Radiology, Vascular & Interventional Radiology providers in Boise
- 1013946235
- 1851335509
- 1952477929
- 1811518038
- 1104188879
- 1740224310
- 1083842033
- 1548502446
- 1760682066
All Radiology, Vascular & Interventional Radiology providers in Idaho →