JACK JIAKUN TIAN (M.D.) – Ophthalmology Physician, NPI 1669907911

JACK JIAKUN TIAN (M.D.) is a healthcare provider. based in Hercules, California. specializing in OPHTHALMOLOGY. They hold the professional credentials M.D.. They hold a License No. MD204184 (OR). The NPI Number for JACK JIAKUN TIAN (M.D.) is 1669907911

Main info

Male
9 Years Of Experience
Name
JACK JIAKUN TIAN (M.D.)
NPI
1669907911
Phone
(510) 918-8237
Address
178 WATERMARK TER
Enumeration Date
25 April 2017
Last Update Date
31 January 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2017 (9 years ago)
PAC ID
9537578588
Professional Enrollment ID
I20220407001644
Address ID
WA981450000SEPOXXXBOXX210
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:9State licenses:2Digital endpointsOther names

1,893 OPHTHALMOLOGY in NY

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Provider Addresses for JACK JIAKUN TIAN (M.D.)

  • 178, Watermark Terrace, Hercules, Contra Costa County, California, 94547, United States

    HERCULES, CA 945472658

    Phone: (510) 918-8237

    Type: Mailing

  • University of Rochester Medical Center, 601, Elmwood Avenue, Upper Mount Hope, Rochester, Monroe, New York, 14611, United States

    BOX MED

    ROCHESTER, NY 146420001

    Phone: (585) 275-2874

    Type: Location

  • 2055 EXCHANGE ST STE 230

    ASTORIA, OR 971033419

    Phone: (503) 338-3803

    Type: Mailing

  • PO BOX 50095

    SEATTLE, WA 981455095

    Phone: (206) 520-5700

    Type: Mailing

  • 325 9TH AVE

    SEATTLE, WA 981042420

    Phone: (206) 520-5000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 46 Open Payments records for all available years, with a total value of $4,410.

Total Amount is formed as General ($4,410) + Research ($0) + Ownership ($0) = $4,410.

Last reported payment date: 2024-12-09 • Largest payer in this snapshot: RxSight Inc ($2,691).

Total Amount

$4,410

General + Research + Ownership

Payments

46

Total payment records

General Amount

$4,410

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2022-04-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210504002700IOphthalmologyORTBD
I20220407001644IOphthalmologyWATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
66984Removal of cataract with insertion of prosthetic lens803457$0
99152Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes747440$0
92136Measurement of corneal curvature and depth of eye485392$0
66821Removal of recurring cataract in lens capsule using a laser297200$0
99204New patient office or other outpatient visit, 45-59 minutes149149$0
View full utilization report →

Insurance plans in this area (ZIP 94547)

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Reviews

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Frequently asked questions

How do I look up JACK JIAKUN TIAN (M.D.) by NPI?
Use NPI 1669907911 when you need to reference JACK JIAKUN TIAN (M.D.) in forms, claims, or directories.
Is JACK JIAKUN TIAN (M.D.) active in the national directory?
JACK JIAKUN TIAN (M.D.)'s public NPI profile is in an active state.
What does JACK JIAKUN TIAN (M.D.) treat or focus on?
Patients typically see JACK JIAKUN TIAN (M.D.) under the specialty Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Does JACK JIAKUN TIAN (M.D.) practice in California?
You will see Hercules, California on file for JACK JIAKUN TIAN (M.D.) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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