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

Sophie Jacobs, PA-C

Individual provider Physician Assistant · NPI 1407603301

Sophie Jacobs, PA-C is a Physician Assistant in Phoenix, Arizona. Qualified in 2024, 2 years ago. Practices with Banner - University Physician Specialists LLC, a 347-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
2
Licensed in
AZ
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1441 N 12th St
Phoenix, AZ 85006-2837
Phone: (602) 521-3050
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 11110 (AZ)

Record details

NPI number1407603301
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 30, 2024
Last updated in NPPESSeptember 10, 2025
Certification dateSeptember 10, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Banner - University Physician Specialists Llc — 347 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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