DR. JAMIE MULANAX JACOBSEN (D.O.) – Family Medicine Physician, NPI 1669447330
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
452 EMERGENCY MEDICINE in KS
Provider Addresses for DR. JAMIE MULANAX JACOBSEN (D.O.)
1117 Goldfinch Rd
Horton, KS 664399537
Phone: (785) 486-2154
Fax: (785) 486-2158
Type: Location
11400 158TH RD
MAYETTA, KS 665098866
Phone: (785) 966-8200
Fax: (785) 966-8393
Type: Mailing
Goldfinch, Longside Lane, Great Horton, Bradford, West Yorkshire, Yorkshire and the Humber, England, BD7 1DF, United Kingdom
HORTON, KS 664399537
Phone: (785) 486-2154
Fax: (785) 486-2158
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2012-10-15
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 |
|---|---|---|---|---|
| I20051212000747 | I | Emergency Medicine | KS | TBD |
| I20121015000274 | I | Family Practice | OK | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 61 | 61 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 41 | 34 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 23 | 23 | $0 |
Insurance plans in this area (ZIP 66439)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | KS | 83036 | Hemoglobin A1C level | 15 | 14 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | KS | |
| Emergency Medicine | KS | |
| Physician Assistant | KS | |
| Nurse Practitioner | KS | |
| Emergency Medicine | MO | |
| Nurse Practitioner | KS | |
| Emergency Medicine | KS | |
| Nurse Practitioner | KS | |
| Nurse Practitioner | KS | |
| Emergency Medicine | MO |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.