ERIK ANDREW JACOBSON (M.D.) – Diagnostic Radiology Physician, NPI 1114389897
Diagnostic Radiology Physician
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Profile Insights
NPPES metrics only — not quality of care.
108 DIAGNOSTIC RADIOLOGY in MT
Provider Addresses for ERIK ANDREW JACOBSON (M.D.)
2120, North 87th Street, Licton Springs, Maple Leaf, Seattle, King County, Washington, 98103, United States
SEATTLE, WA 981034113
Phone:
Type: Mailing
310 Sunnyview Ln
Kalispell, MT 599013129
Phone: (406) 858-6219
Fax: (406) 758-3232
Type: Location
University of Rochester Medical Center, 601, Elmwood Avenue, Upper Mount Hope, Rochester, Monroe, New York, 14611, United States
BOX SURG
ROCHESTER, NY 146420001
Phone: (585) 275-2723
Type: Location
47 NEW SCOTLAND AVE
ALBANY, NY 122083412
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $18.
Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.
Last reported payment date: 2023-03-21 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($18).
Total Amount
$18
General + Research + Ownership
Payments
1
Total payment records
General Amount
$18
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $18 |
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: 2023-07-03
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 |
|---|---|---|---|---|
| I20230703002836 | I | Diagnostic Radiology | MT | 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 |
|---|---|---|---|---|
| 71045 | X-ray of chest, 1 view | 199 | 176 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 89 | 89 | $0 |
| 73502 | X-ray of hip, 2-3 views | 82 | 82 | $0 |
| 71046 | X-ray of chest, 2 views | 81 | 80 | $0 |
| 73562 | X-ray of knee, 3 views | 69 | 65 | $0 |
Insurance plans in this area (ZIP 98103)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | CA | |
| - | MT | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | NM | |
| Diagnostic Radiology | MT | |
| Diagnostic Radiology | MT | |
| - | MT | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | TN | |
| Diagnostic Radiology | VA |
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