DR. LOREN S JACK (M.D.) – Ophthalmology Physician, NPI 1306171970
Ophthalmology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
466 OPHTHALMOLOGY in WA
Provider Addresses for DR. LOREN S JACK (M.D.)
427 S BERNARD ST
SPOKANE, WA 992042509
Phone: (509) 456-0107
Fax: (509) 747-2635
Type: Location
427, South Bernard Street, Spokane, Spokane County, Washington, 99204, United States
SPOKANE, WA 992042509
Phone: (509) 456-0107
Fax: (509) 747-2635
Type: Mailing
Providence Sacred Heart Medical Center and Children's Hospital, 101, West 8th Avenue, Spokane, Spokane County, Washington, 99204, United States
SPOKANE, WA 992042307
Phone: (509) 474-3020
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $168.
Total Amount is formed as General ($168) + Research ($0) + Ownership ($0) = $168.
Last reported payment date: 2024-08-08 • Largest payer in this snapshot: Genentech USA, Inc. ($135).
Total Amount
$168
General + Research + Ownership
Payments
8
Total payment records
General Amount
$168
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
2
Ownership records
Last Payment Date
2024-08-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Genentech USA, Inc. | $135 |
| Regeneron Healthcare Solutions, Inc. | $34 |
| US Retina LLC | $0 |
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: 2015-07-08
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 |
|---|---|---|---|---|
| I20150708000907 | I | Ophthalmology | WA | 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 |
|---|---|---|---|---|
| J2777 | Injection, faricimab-svoa, 0.1 mg | 40,980 | 136 | $0 |
| 92134 | Imaging of retina | 2,672 | 767 | $0 |
| J0178 | Injection, aflibercept, 1 mg | 2,150 | 214 | $0 |
| 67028 | Injection of drug into eye | 1,878 | 386 | $0 |
| J2778 | Injection, ranibizumab, 0.1 mg | 1,293 | 48 | $0 |
Insurance plans in this area (ZIP 99204)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OPHTHALMOLOGY | WA | 92134 | Diagnostic imaging of retina | 1348 | 465 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| O P H T H A L M O L O G Y | WA | |
| O P T O M E T R Y | WA | |
| O P T O M E T R Y | WA | |
| O P T O M E T R Y | CA | |
| O P T O M E T R Y | WA | |
| O P H T H A L M O L O G Y | IA | |
| O P H T H A L M O L O G Y | WA | |
| O P H T H A L M O L O G Y | WA | |
| O P H T H A L M O L O G Y | WA | |
| O P H T H A L M O L O G Y | WA |
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