DEBORAH LYNN JACOBSON (MD) – Pediatric Urology Physician, NPI 1205126257
Pediatric Urology Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
543 UROLOGY in IL
Provider Addresses for DEBORAH LYNN JACOBSON (MD)
225 E CHICAGO AVE # 24
CHICAGO, IL 606112991
Phone:
Type: Mailing
225 E CHICAGO AVE
CHICAGO, IL 606112991
Phone: (615) 495-2828
Type: Location
100 N MARIO CAPECCHI DR STE 3550
SALT LAKE CITY, UT 841131103
Phone: (801) 662-5555
Fax: (801) 662-5547
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $2,418.
Total Amount is formed as General ($2,418) + Research ($0) + Ownership ($0) = $2,418.
Last reported payment date: 2023-08-15 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($2,418).
Total Amount
$2,418
General + Research + Ownership
Payments
5
Total payment records
General Amount
$2,418
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $2,418 |
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: 2020-02-12
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190531001464 | I | Urology | UT | TBD |
| I20200212002433 | I | Pediatric Medicine | 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 60611)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O S U R G E R Y | UT | |
| Pediatric Medicine, Cardiovascular Disease (Cardiology) | UT | |
| Pediatric Medicine | UT | |
| - | UT | |
| - | UT | |
| - | OH | |
| - | UT | |
| - | UT | |
| - | UT | |
| - | UT |
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