Paula I Jacobsen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-008226 Issued in IL

Practice address

704 Crosstown Ave
Silvis, IL 61282-1651

Phone

(309) 796-1444

Fax

(309) 796-1496

NPI assigned

Sep 20, 2005

Last updated

Aug 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Indiana University - School of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jacobsen Eye Care LLCGroup PAC ID 5193170462, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Jacobsen Eye Care LLC

  • Optometrist
  • Silvis, IL
  • NPI 1992488613
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1790771384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 CROSSTOWN AVE",
            "city": "SILVIS",
            "state": "IL",
            "postal_code": "612821651",
            "telephone_number": "309-796-1444",
            "fax_number": "309-796-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 CROSSTOWN AVE",
            "city": "SILVIS",
            "state": "IL",
            "postal_code": "612821651",
            "telephone_number": "309-796-1444",
            "fax_number": "309-796-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "PAULA",
        "middle_name": "I",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1896",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF IL",
            "identifier": "08184019",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hy-Vee Inc (Hy-Vee Pharmacy (1600))
• Illini Clinic Pharmacy Inc
• Illini Clinic Pharmacy Inc (Illini Clinic Pharmacy)
• Illini MRI LLC
• Jacobsen Eye Care LLC
• Jennifer Marie Jensen, RPH
• Freda Mae Diasanta Jordan, RPT
• Helen Kapsas, D.O.
• Lindsey Lee Karzin, NP
• Taylor Keppy, DPT

• Optometrist in Silvis, IL
• Providers in Silvis, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.