KIMBERLY JO JACOBS (PA) – Physician Assistant, NPI 1316003064
Physician Assistant
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for KIMBERLY JO JACOBS (PA)
Coryell Memorial Healthcare System, 1507, West Main Street, Gatesville, Coryell County, Texas, 76528, United States
GATESVILLE, TX 765281024
Phone: (254) 865-2166
Fax: (254) 248-0626
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $230.
Total Amount is formed as General ($230) + Research ($0) + Ownership ($0) = $230.
Last reported payment date: 2024-09-08 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($112).
Total Amount
$230
General + Research + Ownership
Payments
7
Total payment records
General Amount
$230
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Edwards Lifesciences Corporation | $112 |
| Astellas Pharma US Inc | $72 |
| Dexcom, Inc. | $30 |
| BioXcel Therapeutics, Inc. | $16 |
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: 2007-11-13
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 |
|---|---|---|---|---|
| I20071113000681 | I | Physician Assistant | TX | 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 76528)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | TX | |
| General Surgery | TX | |
| Pain Management, Anesthesiology | TX | |
| Family Practice, Emergency Medicine | TX | |
| - | TX | |
| Nurse Practitioner | TX | |
| - | TX | |
| Physician Assistant | TX | |
| Family Practice | TX | |
| A N E S T H E S I O L O G Y | TX |
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