MR. JACOB WAYNE MOSS (M.D., J.D.) – General Practice Physician, NPI 1205179751
General Practice Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
31 GENERAL PRACTICE in ID
Provider Addresses for MR. JACOB WAYNE MOSS (M.D., J.D.)
236 HARVARD AVE
REXBURG, ID 834402211
Phone: (208) 313-1438
Type: Mailing
1995 E 17TH ST
IDAHO FALLS, ID 834046493
Phone: (208) 538-1999
Fax: (208) 881-5295
Type: Location
335 E MAIN ST STE 1
SAINT ANTHONY, ID 834451546
Phone: (208) 356-4900
Fax: (208) 624-4116
Type: Location
PO BOX 18
SAINT ANTHONY, ID 834450018
Phone: (208) 356-4900
Fax: (208) 624-4112
Type: Mailing
3724 Woodking Dr Ste 1
Idaho Falls, ID 83404
Phone: (208) 356-4900
Fax: (208) 612-6118
Type: Location
72 S 1st E Ste 101
Rexburg, ID 834401902
Phone: (208) 356-4900
Fax: (208) 356-3724
Type: Location
241 HARVARD AVE
REXBURG, ID 834402210
Phone: (208) 313-1438
Type: Mailing
283 N 1ST ST
DRIGGS, ID 834225109
Phone: (208) 354-2302
Fax: (208) 354-8392
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $151.
Total Amount is formed as General ($151) + Research ($0) + Ownership ($0) = $151.
Last reported payment date: 2024-12-05 • Largest payer in this snapshot: ABBVIE INC. ($97).
Total Amount
$151
General + Research + Ownership
Payments
7
Total payment records
General Amount
$151
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $97 |
| Teva Pharmaceuticals USA, Inc. | $19 |
| Novo Nordisk Inc | $18 |
| Exact Sciences Corporation | $16 |
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: 2019-12-31
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 |
|---|---|---|---|---|
| I20191231002364 | I | General Practice | ID | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83440)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | ID | |
| Clinical Social Worker | ID | |
| Clinical Social Worker | ID | |
| Clinical Social Worker | ID | |
| Physician Assistant | ID | |
| Clinical Social Worker | ID | |
| Physician Assistant | ID | |
| Clinical Social Worker | ID | |
| Nurse Practitioner | ID | |
| Physician Assistant | ID |
Reviews
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