MR. KALEB L. JACOBS (D.O.) – Obstetrics & Gynecology Physician, NPI 1124468129
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,925 OBSTETRICS/GYNECOLOGY in IL
Provider Addresses for MR. KALEB L. JACOBS (D.O.)
530 NE GLEN OAK AVE
PEORIA, IL 616370001
Phone: (309) 655-3024
Fax: (309) 655-3739
Type: Location
1800 N Knoxville Ave Ste A
Peoria, IL 616033005
Phone: (309) 680-7600
Fax: (309) 495-8614
Type: Location
6708 N. KNOXVILLE AVE
SUITE 1
PEORIA, IL 61614
Phone: (309) 692-6838
Fax: (309) 691-6858
Type: Mailing
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: 2017-10-24
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 |
|---|---|---|---|---|
| I20171024000488 | I | Obstetrics/Gynecology | IL | 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 61637)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | IL | |
| P O D I A T R Y | IL | |
| Nurse Practitioner | NC | |
| Internal Medicine, Pediatric Medicine | IL | |
| Internal Medicine, Pediatric Medicine | IL | |
| Internal Medicine, Pediatric Medicine | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| Nurse Practitioner | IL | |
| Internal Medicine | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL |
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