Andre Jack Jacobsen
NPI 1629574223ActiveIndividual· Anesthesiology· Anchorage, AK
Anesthesiology in Anchorage, Alaska, trained at Medical College of Wisconsin (class of 2018). Medicare paid $110,328 for services to 255 patients in 2024.
Overview
| NPI | 1629574223 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Apr 3, 2018 |
| Last updated in NPPES | Sep 7, 2023 |
| Certified by provider | Sep 7, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Anesthesiology Primary | 207L00000X | 200882 | AK |
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 Practitioner - Anesthesiology (AK) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 255 |
|---|---|
| Services billed | 388 across 69 procedure codes |
| Paid by Medicare | $110,328 |
Education and affiliations
| Medical school | Medical College of Wisconsin |
|---|---|
| Graduation year | 2018 |
| Medicare specialty | Anesthesiology |
Medical group
- Providence Anchorage Anesthesia Medical Group PCAnchorage, AK · 54 clinicians
Hospital affiliation
- Providence Alaska Medical CenterAnchorage, AK
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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