Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Andre Jack Jacobsen

Individual provider Anesthesiology Physician · NPI 1629574223

Andre Jack Jacobsen is an Anesthesiology in Anchorage, Alaska. Graduated from Medical College of Wisconsin in 2018, 8 years ago. Practices with Providence Anchorage Anesthesia Medical Group PC, a 53-clinician group and accepts Medicare assignment. Licensed in Alaska.

Years since qualifying
8
Trained at
Medical College of Wisconsin
Licensed in
AK
In the registry since
2018
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Practice location Address checks out

3300 Providence Dr Ste 205
Anchorage, AK 99508-4620
Phone: (907) 561-1510
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Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 200882 (AK)

Record details

NPI number1629574223
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 3, 2018
Last updated in NPPESSeptember 7, 2023
Certification dateSeptember 7, 2023
Mailing address3300 Providence Dr Ste 205, Anchorage, AK 99508-4620

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2018 (8 years in practice)
Group practice Providence Anchorage Anesthesia Medical Group Pc — 53 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Anchorage