DR. JACOB PETERSEN CHAFFEE (MD) – Family Medicine Physician, NPI 1811983562

DR. JACOB PETERSEN CHAFFEE (MD) is a healthcare provider. based in Grand coulee, Washington. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. MD00042597 (WA). The NPI Number for DR. JACOB PETERSEN CHAFFEE (MD) is 1811983562

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
DR. JACOB PETERSEN CHAFFEE (MD)
NPI
1811983562
Phone
(509) 633-1753
Address
411 FORTUYN RD
Enumeration Date
27 September 2005
Last Update Date
14 March 2018

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
5096331753
Graduation Year
2001 (25 years ago)
PAC ID
5799698403
Group Practice PAC ID
9335050285
Professional Enrollment ID
I20041201000991
Address ID
WA991338718GR411XXRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,141 FAMILY PRACTICE in WA

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Provider Addresses for DR. JACOB PETERSEN CHAFFEE (MD)

  • 411, Fortuyn Road, Grand Coulee, Grant County, Washington, 99133, United States

    GRAND COULEE, WA 991338718

    Phone: (509) 633-1753

    Fax: (509) 633-1933

    Type: Mailing

  • 411 Fortuyn Rd

    Coulee Community Hospital

    Grand Coulee, WA 991338718

    Phone: (509) 633-1753

    Fax: (509) 633-1930

    Type: Location

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.

This can happen when there are no reportable CMS Open Payments records.

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: 2003-11-10

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20031110000209IFamily PracticeWATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 99133)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9335050285View full group profile
NameSpecialtyState
Nurse PractitionerWA
Internal Medicine, Internal Medicine, Pulmonary Disease, General Surgery, Critical Care (Intensivists)IA
-WA
Nurse PractitionerWA
Family Practice, Obstetrics/GynecologyWA
Nurse PractitionerVA
Certified Registered Nurse Anesthetist (Crna)WA
Family PracticeIN
Physician AssistantTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

Can I verify DR. JACOB PETERSEN CHAFFEE (MD) with an NPI only?
You can start verification with NPI 1811983562 for DR. JACOB PETERSEN CHAFFEE (MD), then check state licensing separately.
Is DR. JACOB PETERSEN CHAFFEE (MD) still practicing?
DR. JACOB PETERSEN CHAFFEE (MD) is currently listed as active in the public NPI registry.
What is DR. JACOB PETERSEN CHAFFEE (MD)'s specialty?
The listing groups DR. JACOB PETERSEN CHAFFEE (MD) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for DR. JACOB PETERSEN CHAFFEE (MD)?
DR. JACOB PETERSEN CHAFFEE (MD)'s geographic hint is Grand Coulee, Washington in our summary view.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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