DR. KEVIN SEAN JACOB (O.D.) – Optometrist, NPI 1124173521
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
700 OPTOMETRY in KY
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Provider Addresses for DR. KEVIN SEAN JACOB (O.D.)
Walmart Supercenter, 20, Ferguson Boulevard, Dry Ridge, Grant County, Kentucky, 41035, United States
DRY RIDGE, KY 410358635
Phone: (859) 824-1333
Type: Location
9100, Brantley Way, Plantation Pointe, Florence, Boone County, Kentucky, 41042, United States
FLORENCE, KY 410428684
Phone: (859) 384-7646
Type: Mailing
800 Heights Blvd
Florence, KY 410421415
Phone: (859) 568-7015
Fax: (859) 568-7016
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $34.
Total Amount is formed as General ($34) + Research ($0) + Ownership ($0) = $34.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: Stryker Corporation ($34).
Total Amount
$34
General + Research + Ownership
Payments
1
Total payment records
General Amount
$34
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Stryker Corporation | $34 |
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: 2010-03-30
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 |
|---|---|---|---|---|
| I20100330000189 | I | Optometry | KY | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 33 | 33 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 14 | 14 | $0 |
Insurance plans in this area (ZIP 41035)
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