DR. CARL H. JACOBSEN (O.D.) – Optometrist, NPI 1003941766
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,909 OPTOMETRY in CA
Provider Addresses for DR. CARL H. JACOBSEN (O.D.)
200 MINOR HALL
UC BERKELEY
BERKELEY, CA 947202020
Phone: (510) 643-9826
Fax: (510) 642-4025
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $289.
Total Amount is formed as General ($289) + Research ($0) + Ownership ($0) = $289.
Last reported payment date: 2023-10-24 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($143).
Total Amount
$289
General + Research + Ownership
Payments
4
Total payment records
General Amount
$289
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Bausch & Lomb Americas Inc. | $143 |
| Alcon Vision LLC | $119 |
| Carl Zeiss Meditec, Inc. | $27 |
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: 2009-01-22
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 |
|---|---|---|---|---|
| I20090122000232 | I | Optometry | CA | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 736 | 408 | $0 |
| 92083 | Exam of visual field with extended testing | 258 | 195 | $0 |
| 92014 | Established patient complete exam of visual system | 216 | 215 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 177 | 148 | $0 |
| 92133 | Imaging of optic nerve | 154 | 151 | $0 |
Insurance plans in this area (ZIP 94720)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | CA | |
| O P T O M E T R Y | MA | |
| O P T O M E T R Y | CA | |
| O P T O M E T R Y | CA | |
| O P T O M E T R Y | CA | |
| O P T O M E T R Y | CA | |
| O P T O M E T R Y | CA | |
| O P H T H A L M O L O G Y | CA | |
| O P T O M E T R Y | CA | |
| O P T O M E T R Y | CA |
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