DR. JACOB JOSEPH TOM (MD) – Diagnostic Radiology Physician, NPI 1912972258
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
532 DIAGNOSTIC RADIOLOGY in OR
Provider Addresses for DR. JACOB JOSEPH TOM (MD)
960 N 16TH ST STE 103
SPRINGFIELD, OR 974774175
Phone: (541) 726-4694
Fax: (541) 744-6069
Type: Location
696, North Shepherd Road, Parkersville, Washougal, Clark County, Washington, 98671, United States
WASHOUGAL, WA 986718320
Phone: (360) 281-6432
Type: Mailing
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.
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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: 2008-06-03
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 |
|---|---|---|---|---|
| I20080603000288 | I | Diagnostic Radiology | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 77067 | Screening mammography | 593 | 593 | $0 |
| 77080 | Dxa bone density measurement of hip, pelvis, spine | 227 | 227 | $0 |
| 76641 | Complete ultrasound scan of 1 breast | 41 | 39 | $0 |
| 76700 | Complete ultrasound scan of abdomen | 32 | 32 | $0 |
| 76881 | Complete ultrasound scan of joint | 28 | 27 | $0 |
Insurance plans in this area (ZIP 97477)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | OR | 73110 | X-ray of wrist, minimum of 3 views | 27 | 18 |
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