ALAN PETER JAKUBOWSKI (M.D.) – Physical Medicine & Rehabilitation Physician, NPI 1609964261

ALAN PETER JAKUBOWSKI (M.D.) is a healthcare provider. based in Appleton, Wisconsin. specializing in PHYSICAL MEDICINE AND REHABILITATION. They hold the professional credentials M.D.. They hold a License No. 37882 (MN). The NPI Number for ALAN PETER JAKUBOWSKI (M.D.) is 1609964261

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
ALAN PETER JAKUBOWSKI (M.D.)
NPI
1609964261
Phone
(920) 831-5050
Address
900 E GRANT ST
Enumeration Date
10 October 2006
Last Update Date
6 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2098573400
Graduation Year
1993 (33 years ago)
PAC ID
7618960816
Professional Enrollment ID
I20080212000224
Address ID
CA953551119MO1303XAVEX300

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
Experience85
Completeness85
Years active:19State licenses:3Other namesUpdated within 12 months

1,154 PHYSICAL MEDICINE AND REHABILITATION in CA

Provider Addresses for ALAN PETER JAKUBOWSKI (M.D.)

  • 900, East Grant Street, Huntley Houses, Appleton, Outagamie County, Wisconsin, 54911, United States

    APPLETON, WI 549113487

    Phone: (920) 831-5050

    Type: Mailing

  • 3975 Old Redwood Hwy Ste 152

    Santa Rosa, CA 954031719

    Phone: (707) 566-5669

    Fax: (707) 566-5517

    Type: Location

  • 3975 OLD REDWOOD HWY STE 152

    SANTA ROSA, CA 954031719

    Phone: (707) 566-5669

    Fax: (707) 566-5517

    Type: Mailing

  • PO BOX 5074

    SIOUX FALLS, SD 571175074

    Phone: (605) 328-6585

    Fax: (605) 312-9802

    Type: Mailing

  • 736 BROADWAY N

    FARGO, ND 581024421

    Phone: (701) 234-2000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $43.

Total Amount is formed as General ($43) + Research ($0) + Ownership ($0) = $43.

Last reported payment date: 2024-03-21 • Largest payer in this snapshot: PIRAMAL CRITICAL CARE ($24).

Total Amount

$43

General + Research + Ownership

Payments

2

Total payment records

General Amount

$43

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-21

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-01-23

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20080212000224IPhysical Medicine And RehabilitationCATBD
I20240123003223IPhysical Medicine And RehabilitationNDTBD

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 54911)

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Reviews

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Frequently asked questions

Can I verify ALAN PETER JAKUBOWSKI (M.D.) with an NPI only?
You can start verification with NPI 1609964261 for ALAN PETER JAKUBOWSKI (M.D.), then check state licensing separately.
Can I rely on ALAN PETER JAKUBOWSKI (M.D.) being an active provider?
As of the registry snapshot, ALAN PETER JAKUBOWSKI (M.D.) is marked active.
What taxonomy line describes ALAN PETER JAKUBOWSKI (M.D.)?
For research purposes, treat ALAN PETER JAKUBOWSKI (M.D.) as Physical Medicine & Rehabilitation Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for ALAN PETER JAKUBOWSKI (M.D.)?
ALAN PETER JAKUBOWSKI (M.D.)'s geographic hint is Appleton, Wisconsin in our summary view.
Is the information about ALAN PETER JAKUBOWSKI (M.D.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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