RACHAEL SUE JACOBY (MD) – Ophthalmology Physician, NPI 1265659213
Ophthalmology Physician
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Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
279 PEDIATRIC MEDICINE in UT
Provider Addresses for RACHAEL SUE JACOBY (MD)
PO BOX 413075
SALT LAKE CITY, UT 841413075
Phone: (801) 213-3900
Type: Mailing
65 MARIO CAPECCHI DR
SALT LAKE CITY, UT 841320001
Phone: (801) 581-2352
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $161.
Total Amount is formed as General ($161) + Research ($0) + Ownership ($0) = $161.
Last reported payment date: 2024-10-22 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($109).
Total Amount
$161
General + Research + Ownership
Payments
6
Total payment records
General Amount
$161
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Regeneron Healthcare Solutions, Inc. | $109 |
| Astellas Pharma US Inc | $28 |
| Genentech USA, Inc. | $23 |
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: 2007-06-13
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 |
|---|---|---|---|---|
| I20070613000275 | I | Pediatric Medicine | UT | 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 |
|---|---|---|---|---|
| 92134 | Imaging of retina | 1,299 | 488 | $0 |
| 67028 | Injection of drug into eye | 863 | 211 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 543 | 389 | $0 |
| 92250 | Photography of the retina | 159 | 138 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 159 | 138 | $0 |
Insurance plans in this area (ZIP 84141)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| O P H T H A L M O L O G Y | UT | |
| O P H T H A L M O L O G Y | UT | |
| O P H T H A L M O L O G Y | SD | |
| - | UT | |
| O P H T H A L M O L O G Y | UT | |
| O P H T H A L M O L O G Y | UT | |
| O P H T H A L M O L O G Y | MN | |
| O P H T H A L M O L O G Y | UT |
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