JACOB DAVID SAMS (MD) – Orthopaedic Surgery Physician, NPI 1730340498
Orthopaedic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,265 ORTHOPEDIC SURGERY in IL
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Provider Addresses for JACOB DAVID SAMS (MD)
PO BOX 9632
SPRINGFIELD, IL 627919632
Phone: (217) 864-2665
Fax: (217) 864-8042
Type: Mailing
104, Ashland Avenue, Mount Zion, Macon County, Illinois, 62549, United States
MT. ZION, IL 62549
Phone: (217) 864-2665
Fax: (217) 864-8042
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 17 Open Payments records for all available years, with a total value of $13,551.
Total Amount is formed as General ($3,187) + Research ($10,363) + Ownership ($0) = $13,551.
Last reported payment date: 2024-07-31 • Largest payer in this snapshot: Canary Medical USA LLC ($10,363).
Total Amount
$13,551
General + Research + Ownership
Payments
17
Total payment records
General Amount
$3,187
General payments
Research Amount
$10,363
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Canary Medical USA LLC | $10,363 |
| Zimmer Biomet Holdings, Inc. | $3,119 |
| DePuy Synthes Sales Inc. | $46 |
| Organogenesis Inc. | $22 |
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: 2013-07-19
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 |
|---|---|---|---|---|
| I20130719000187 | I | Orthopedic Surgery | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 1,637 | 234 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 479 | 310 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 371 | 284 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 303 | 228 | $0 |
| 73562 | X-ray of knee, 3 views | 249 | 129 | $0 |
Insurance plans in this area (ZIP 62791)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | IL | |
| Orthopedic Surgery, Plastic And Reconstructive Surgery | IL | |
| - | IL | |
| Nurse Practitioner | IL | |
| Physical Therapist In Private Practice | IL | |
| Nurse Practitioner | IL | |
| P O D I A T R Y | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL |
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