DR. LARS JAKOB JAKOBSEN (M.D.) – Internal Medicine Physician, NPI 1417933110

DR. LARS JAKOB JAKOBSEN (M.D.) is a healthcare provider. based in Auburn, California. specializing in INTERNAL MEDICINE. They hold the professional credentials M.D.. They hold a License No. G077316 (CA). The NPI Number for DR. LARS JAKOB JAKOBSEN (M.D.) is 1417933110

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
DR. LARS JAKOB JAKOBSEN (M.D.)
NPI
1417933110
Phone
(530) 885-5618
Address
3111 PROFESSIONAL DR
Enumeration Date
15 December 2005
Last Update Date
15 December 2021

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Secondary Phone
9167844050
Graduation Year
1992 (34 years ago)
PAC ID
3577638030
Group Practice PAC ID
8921910225
Professional Enrollment ID
I20080818000541
Address ID
CA956785134RO1011XAVEX300
Telehealth
Yes

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

21,558 INTERNAL MEDICINE in CA

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Provider Addresses for DR. LARS JAKOB JAKOBSEN (M.D.)

  • Western Sierra Medical Clinic, 3111, Professional Drive, Auburn, Placer County, California, 95603, United States

    AUBURN, CA 956032456

    Phone: (530) 885-5618

    Fax: (530) 889-0636

    Type: Location

  • 9708 MAGELLAN DR

    LOOMIS, CA 956509736

    Phone: (530) 652-3102

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-08-18

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080818000541IInternal MedicineCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95603)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921910225View full group profile
NameSpecialtyState
Emergency MedicineDC
-CA
N E U R O S U R G E R YMA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
-MA
Emergency MedicineCA
-CA
Internal MedicineNY

Reviews

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Frequently asked questions

Does DR. LARS JAKOB JAKOBSEN (M.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. LARS JAKOB JAKOBSEN (M.D.) uses 1417933110.
Can I rely on DR. LARS JAKOB JAKOBSEN (M.D.) being an active provider?
As of the registry snapshot, DR. LARS JAKOB JAKOBSEN (M.D.) is marked active.
What taxonomy line describes DR. LARS JAKOB JAKOBSEN (M.D.)?
For research purposes, treat DR. LARS JAKOB JAKOBSEN (M.D.) as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is DR. LARS JAKOB JAKOBSEN (M.D.) based?
DR. LARS JAKOB JAKOBSEN (M.D.) is tied to Auburn, California in the data we show; additional addresses may exist on the full record.
Is the information about DR. LARS JAKOB JAKOBSEN (M.D.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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