THERESA A JACOBSEN (NP) – Nurse Practitioner, NPI 1689667883
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,509 NURSE PRACTITIONER in AZ
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Provider Addresses for THERESA A JACOBSEN (NP)
Dance Connection 2, 2250, East Germann Road, Chandler, Maricopa County, Arizona, 85225-2412, United States
STE 2
CHANDLER, AZ 85286
Phone: (480) 878-5306
Type: Mailing
2304, East Geneva Drive, Tempe, Maricopa County, Arizona, 85282, United States
TEMPE, AZ 852824147
Phone: (480) 878-5306
Type: Location
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: 2005-06-01
PECOS data refreshed: 2026-05-27
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050601000158 | I | Nurse Practitioner | AZ | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 1,046 | 124 | $0 |
| G0182 | Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patien | 186 | 58 | $0 |
| 99497 | Advance care planning, first 30 minutes | 100 | 76 | $0 |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | 47 | 46 | $0 |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 60 minutes | 34 | 32 | $0 |
Insurance plans in this area (ZIP 85286)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ | |
| - | AZ | |
| - | AZ | |
| - | AZ | |
| Nurse Practitioner | OR | |
| - | AZ | |
| Occupational Therapist In Private Practice | NY | |
| - | AZ | |
| Physician Assistant | AZ |
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