JACOB RAY JENNESS (OD) – Optometrist, NPI 1326787763

JACOB RAY JENNESS (OD) is a healthcare provider. based in Bloomington, Minnesota. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 3793 (MN). The NPI Number for JACOB RAY JENNESS (OD) is 1326787763

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
JACOB RAY JENNESS (OD)
NPI
1326787763
Phone
(952) 567-6125
Address
9801 DUPONT AVE S STE 425
Enumeration Date
2 June 2022
Last Update Date
2 October 2023

Doctor Profile

Medical School Name
FERRIS STATE COLLEGE - COLLEGE OF OPTOMETRY
Secondary Phone
7123361960
Graduation Year
2022 (4 years ago)
PAC ID
7618356957
Group Practice PAC ID
1951295047
Professional Enrollment ID
I20230831003421
Address ID
IA513601044SP2312XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

879 OPTOMETRY in MN

Provider Addresses for JACOB RAY JENNESS (OD)

  • 9801 DUPONT AVE S STE 425

    BLOOMINGTON, MN 554313873

    Phone: (952) 567-6125

    Fax: (952) 567-6176

    Type: Mailing

  • 9801 DUPONT AVE S STE 200

    BLOOMINGTON, MN 554313200

    Phone: (952) 888-5800

    Fax: (952) 567-6156

    Type: Location

  • 2312 23RD ST

    SPIRIT LAKE, IA 513601044

    Phone: (712) 336-1960

    Fax: (952) 567-6176

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 13 Open Payments records for all available years, with a total value of $414.

Total Amount is formed as General ($414) + Research ($0) + Ownership ($0) = $414.

Last reported payment date: 2024-09-09 • Largest payer in this snapshot: BIOTISSUE HOLDINGS, INC. ($141).

Total Amount

$414

General + Research + Ownership

Payments

13

Total payment records

General Amount

$414

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-09

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2023-08-31

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230831003421IOptometryIATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system204204$0
99214Established patient office or other outpatient visit, 30-39 minutes9894$0
99213Established patient office or other outpatient visit, 20-29 minutes8666$0
92134Imaging of retina7474$0
76514Ultrasound scan of cornea to determine thickness5353$0
View full utilization report →

Insurance plans in this area (ZIP 55431)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951295047View full group profile

Reviews

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Frequently asked questions

What identifier follows JACOB RAY JENNESS (OD) across health systems?
The NPI 1326787763 uniquely identifies JACOB RAY JENNESS (OD) in U.S. healthcare data.
Should I treat JACOB RAY JENNESS (OD) as an active provider?
Patients and plans typically see JACOB RAY JENNESS (OD) as active in the national extract.
Which specialty label fits JACOB RAY JENNESS (OD)?
NPPES ties JACOB RAY JENNESS (OD) to Optometrist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to JACOB RAY JENNESS (OD)?
JACOB RAY JENNESS (OD) is associated with Bloomington, Minnesota in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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