Individual provider Active NPI

Jacob Eby, M.D.

  • Pediatrics Physician
  • Wasilla, AK
National Provider Identifier
1295112159
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD463351 Issued in PA
Practice address
1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083
Phone
(907) 729-3300
Fax
(907) 729-6351
NPI assigned
Apr 29, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD463351 PA Primary
Pediatrics Physician 208000000X 01098741A IN
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083

Mailing address

7033 E Tudor Rd
Anchorage, AK 99507-1262
Phone (907) 729-6351

Other practice location 1

1 Childrens Plz
Dayton, OH 45404-1873
Phone (937) 641-3433 ext. 1

Other practice location 2

2001 W 86th St
Indianapolis, IN 46260-1902
Phone (317) 338-6815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220927002201 TX Practitioner - Pediatric Medicine 3870914575 Reassigns benefits to 2 organizations
I20260528003595 IN Practitioner - Pediatric Medicine 3870914575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Toledo Medical College, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

250 W 96TH St
Suite 520
Indianapolis, IN 46260-1317

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01098741AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation Current Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince May 1, 2023 Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation CurrentSince Aug 1, 2022 Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation Past Accepting new patients
Alaska Pediatric Night Clinic, Inc. Pediatrics Past Accepting new patients
Southcentral Foundation Past Accepting new patients

Locations

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1295112159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7033 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071262",
            "telephone_number": "907-729-6351",
            "fax_number": "907-729-8607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S KNIK GOOSE BAY RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548083",
            "telephone_number": "907-729-3300",
            "fax_number": "907-729-6351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Childrens Plz",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454041873",
            "country_code": "US",
            "telephone_number": "937-641-3433 x1",
            "fax_number": "937-641-5931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 W 86th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601902",
            "country_code": "US",
            "telephone_number": "317-338-6815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBY",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-29",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD463351",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01098741A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.