JAKE VRDOLJAK (MD) – Diagnostic Radiology Physician, NPI 1619976230

JAKE VRDOLJAK (MD) is a healthcare provider. based in Omaha, Nebraska. specializing in DIAGNOSTIC RADIOLOGY. They hold the professional credentials MD. They hold a License No. 13076C (WY). The NPI Number for JAKE VRDOLJAK (MD) is 1619976230

Main info

Male
32 Years Of Experience
Name
JAKE VRDOLJAK (MD)
NPI
1619976230
Phone
(833) 228-6889
Address
17310 WRIGHT ST
Enumeration Date
15 July 2005
Last Update Date
23 September 2025

Doctor Profile

Medical School Name
CHICAGO COLLEGE OF MEDICINE AND SURGERY
Secondary Phone
5088627777
Graduation Year
1994 (32 years ago)
PAC ID
8527253400
Group Practice PAC ID
2961872452
Professional Enrollment ID
I20101117001150
Address ID
VA222072851AR5210XDRXX401

Contacts

Main Contact
https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience95
Completeness95
Years active:20State licenses:8Other names

1,084 DIAGNOSTIC RADIOLOGY in MD

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Provider Addresses for JAKE VRDOLJAK (MD)

  • 17310 WRIGHT ST

    STE 103

    OMAHA, NE 681302405

    Phone: (833) 228-6889

    Fax: (877) 853-0376

    Type: Mailing

  • 8926, Woodyard Road, Ballard, Clinton, Prince George's County, Maryland, 20735, United States

    SUITE 301

    CLINTON, MD 20735

    Phone: (301) 856-3670

    Fax: (301) 868-0129

    Type: Location

  • 7801, Old Branch Avenue, Jenkins Corner, Clinton, Prince George's County, Maryland, 20735, United States

    SUITE 300

    CLINTON, MD 20735

    Phone: (301) 856-6718

    Fax: (301) 856-6722

    Type: Mailing

  • 500 E Market St

    Iowa City, IA 522452633

    Phone: (319) 339-3551

    Fax: (319) 248-7945

    Type: Location

  • 6000 Hospital Dr

    Hannibal, MO 634016887

    Phone: (573) 248-5301

    Fax: (573) 248-5302

    Type: Location

  • 2305 37th Ave SW

    Minot, ND 587017669

    Phone: (701) 857-5000

    Type: Location

  • 701 W Forevergreen Rd

    North Liberty, IA 523179848

    Phone: (319) 356-3375

    Fax: (319) 356-3949

    Type: Location

  • 1 Burdick Expy W

    Minot, ND 587014406

    Phone: (701) 857-5000

    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: 2025-11-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 20 Medicare enrollment records; no due dates published yet.

Enrollment records

20

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
I20101117001150IDiagnostic RadiologyDCTBD
I20130708000668IDiagnostic RadiologyVATBD
I20130709000096IDiagnostic RadiologyMDTBD
I20201109000080IDiagnostic RadiologyTXTBD
I20201110001507IDiagnostic RadiologyWITBD
I20210121000997IDiagnostic RadiologyTNTBD
I20210121002573IDiagnostic RadiologyMNTBD
I20210526001489IDiagnostic RadiologyIATBD
I20210611002121IDiagnostic RadiologyMATBD
I20220210002454IDiagnostic RadiologyNDTBD
I20230217001177IDiagnostic RadiologyARTBD
I20230225000422IDiagnostic RadiologyMOTBD
I20230424000453IDiagnostic RadiologyWYTBD
I20230623001900IDiagnostic RadiologyILTBD
I20240515001468IDiagnostic RadiologySCTBD
I20240620003243IDiagnostic RadiologySDTBD
I20241025002137IDiagnostic RadiologyWATBD
I20250416002535IDiagnostic RadiologyCATBD
I20250502000832IDiagnostic RadiologyNMTBD
I20251124000693IDiagnostic RadiologyNETBD

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
Q9967Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml5,63052$0
71045X-ray of chest, 1 view348326$0
70450Ct scan head or brain without contrast242239$0
71046X-ray of chest, 2 views239238$0
A9578Injection, gadobenate dimeglumine (multihance multipack), per ml23522$0
View full utilization report →

Insurance plans in this area (ZIP 68130)

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Provider's Procedures

JAKE VRDOLJAK (MD) performs procedures in DIAGNOSTIC RADIOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYMD71250CT scan chest2323
DIAGNOSTIC RADIOLOGYMD74177CT scan of abdomen and pelvis with contrast3232
DIAGNOSTIC RADIOLOGYMD76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle3232
DIAGNOSTIC RADIOLOGYMD78815Nuclear medicine study with CT imaging skull base to mid-thigh5755
DIAGNOSTIC RADIOLOGYMD93971Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers5555

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: 2961872452View full group profile
NameSpecialtyState
Diagnostic RadiologyNE
Diagnostic RadiologyIA
Diagnostic RadiologyIA
Diagnostic RadiologyAZ

Reviews

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Frequently asked questions

Can I use this page to confirm JAKE VRDOLJAK (MD)'s NPI?
Yes. JAKE VRDOLJAK (MD) is listed with NPI 1619976230 in the public NPI dataset.
Does CMS list JAKE VRDOLJAK (MD) as active?
Yes — JAKE VRDOLJAK (MD) is active in the NPI listing used on this page.
What taxonomy line describes JAKE VRDOLJAK (MD)?
For research purposes, treat JAKE VRDOLJAK (MD) as Diagnostic Radiology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does JAKE VRDOLJAK (MD) list a practice location?
Patients near Omaha, Nebraska may find JAKE VRDOLJAK (MD) in results; validate coverage separately.
Why does JAKE VRDOLJAK (MD) have multiple addresses?
8 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.