JEFFRY ALAN JACOBS (MEDICAL DOCTOR) – Child & Adolescent Psychiatry Physician, NPI 1063477545
Child & Adolescent Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JEFFRY ALAN JACOBS (MEDICAL DOCTOR)
3608 FARAON ST
SAINT JOSEPH, MO 645063044
Phone: (816) 232-4417
Type: Location
402 S 4th Ave
Central Washington Comprehensive Mental Health
Yakima, WA 98902
Phone: (509) 575-4084
Fax: (509) 576-4302
Type: Location
1170 Pearl St
Eugene, OR 974013541
Phone: (541) 743-4340
Type: Location
12932 ORCHARD CROSSING LN
KNOXVILLE, TN 379341222
Phone: (865) 202-2209
Fax: (865) 321-8900
Type: Mailing
402, South 4th Avenue, Yakima, Yakima County, Washington, 98902, United States
CENTRAL WASHINGTON COMPREHENSIVE MENTAL HEALTH
YAKIMA, WA 98902
Phone: (509) 575-4084
Fax: (509) 576-4302
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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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: 2023-12-22
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 |
|---|---|---|---|---|
| I20151008002069 | I | Psychiatry | WA | TBD |
| I20231222002631 | I | Psychiatry | OR | 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 64506)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WA | |
| Nurse Practitioner | WA | |
| Mental Health Counselor | WA | |
| Nurse Practitioner | MN | |
| Nurse Practitioner | WA | |
| Mental Health Counselor | WA | |
| Mental Health Counselor | WA | |
| Nurse Practitioner | LA | |
| Clinical Social Worker | WA | |
| Clinical Social Worker | WA |
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