Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Andre Jack Jacobsen

Individual provider Anesthesiology Physician · NPI 1629574223

Andre Jack Jacobsen practises 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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Pin is approximate — placed at the ZIP-code centre, not the exact door.

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

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

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients255
Services billed 388 a service is one billed item, such as a visit, a test or a procedure
Average patient age73

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Providence Anchorage Anesthesia Medical Group PC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 53 clinicians in the practice; 12 are shown here.

Other providers in Anchorage