JACOB JOHNSON (D.O.) – Emergency Medicine Physician, NPI 1689055154
Emergency Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
3,050 FAMILY PRACTICE in WI
Provider Addresses for JACOB JOHNSON (D.O.)
900 W Clairemont Ave
Eau Claire, WI 547016122
Phone: (715) 717-4121
Type: Location
2661 County Highway I
Chippewa Falls, WI 547295407
Phone: (715) 723-1811
Type: Location
7090 STEVENSVILLE BARODA RD
STEVENSVILLE, MI 491279782
Phone: (715) 497-2112
Type: Mailing
405 STAGELINE RD
HUDSON, WI 540167848
Phone: (715) 531-6000
Type: Location
265 Griffin St E
Amery, WI 540011439
Phone: (715) 268-8000
Type: Location
535 Hospital Rd
New Richmond, WI 540171449
Phone: (715) 243-2600
Type: Location
640 Jackson St
Saint Paul, MN 551012502
Phone: (651) 254-3456
Type: Location
1234 Napier avenue
Lakeland Health-GME
Saint joseph, MI 49085
Phone: (269) 982-4941
Type: Location
1705 16th Ave
Cumberland, WI 548298601
Phone: (715) 822-7500
Fax: (715) 822-7221
Type: Location
2661 COUNTY HIGHWAY I
CHIPPEWA FALLS, WI 547295407
Phone: (715) 723-1811
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: 2024-07-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20190813002339 | I | Emergency Medicine | WI | TBD |
| I20240731000705 | I | Family Practice | MN | 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 54701)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| Clinical Psychologist | MN | |
| - | MN | |
| P S Y C H I A T R Y | MN | |
| Family Practice | MN | |
| - | MN | |
| - | MN | |
| P O D I A T R Y | MN | |
| Physician Assistant | MN | |
| Physician Assistant | MN |
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