Mark A Jacobs, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1201DT Issued in KY

Practice address

3810 S Highway 27
Suite 1
Somerset, KY 42501-3073

Phone

(606) 678-4551

Fax

(606) 678-0972

NPI assigned

Jun 17, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 8

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University Alabama Birmingham - School of Optometry, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associates in Eye Care IncGroup PAC ID 7012908643, 12 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjacobs.keca@direct.ocuhub.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Associates in Eye Care, Inc.

  • Optometrist
  • Somerset, KY
  • NPI 1649377177
  Medicare reassignment Care Compare group NPD
• Associates in Eye Care, Inc.

  • Optometrist
  • Russell Springs, KY
  • NPI 1437691276
  NPD
• Associates in Eye Care, Inc.

  • Optometrist
  • Albany, KY
  • NPI 1720190101
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1124023809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306",
            "city": "FERGUSON",
            "state": "KY",
            "postal_code": "425330306",
            "telephone_number": "606-492-2211",
            "fax_number": "606-676-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 S HIGHWAY 27",
            "address_2": "SUITE 1",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425013073",
            "telephone_number": "606-678-4551",
            "fax_number": "606-678-0972"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 Foothills Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "KY",
            "postal_code": "426021037",
            "country_code": "US",
            "telephone_number": "606-387-5612",
            "fax_number": "606-387-6602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1201DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410028407",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "380000269",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100209960",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTN/BLUECARE/TENNCARE",
            "identifier": "127554",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4599154",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100209970",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "00160523",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77012011",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "COMPULINK",
            "affiliation": "N",
            "endpointDescription": "SECURE SOFTWARE",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ELECTRONIC HEALTH RECORDS",
            "address_1": "3810 S Highway 27",
            "address_2": "Suite 1",
            "city": "Somerset",
            "state": "KY",
            "country_code": "US",
            "postal_code": "425013073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eric Joseph Iribar, DO
• Lacey Renee Irvine, LPCC
• Betty L Isaacs, LPCA
• Kelsey Isaacs
• Carmellia Kay Jackson, CSW, MFT-ASSOCIATE
• Kristin Jacobson, MSW
• James Medical Equipment, LTD
• Sarah Jarvis, MA
• Chris Michael Jasper, LPCC
• Julianne Jasper, BCBA

• Optometrist in Somerset, KY
• Providers in Somerset, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.