Jacob Thomas Depolo, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

64086 Issued in TN

Practice address

2001 Laurel Ave # N304
Knoxville, TN 37916-1810

Phone

(865) 766-6870

NPI assigned

Apr 8, 2018

Sex

Male

Sole proprietor

No

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.

• Vista Radiology, PC.

  • Diagnostic Radiology Physician
  • Knoxville, TN
  • NPI 1386698710

  TN, Vascular & Interventional Radiology

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fort Sanders Regional Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1942294814

  Hospital

  Care Compare affiliation
• Leconte Medical Center

  • General Acute Care Hospital
  • Sevierville, TN
  • NPI 1528052578

  Hospital

  Care Compare affiliation
• Morristown Hamblen Hospital Association

  • General Acute Care Hospital
  • Morristown, TN
  • NPI 1912997024

  Hospital

  Care Compare affiliation
• Parkwest Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1396739165

  Hospital

  Care Compare affiliation
• Roane County Medical Center

  • General Acute Care Hospital
  • Harriman, TN
  • NPI 1700036696

  Hospital

  Care Compare affiliation

Specialty

Interventional Radiology

Education

JC Edwards School of Medicine, Marshall University, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vista Radiology, PC 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173
• Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125
• Leconte Medical Center Hospital, Sevierville, TN, CCN 440081
• Morristown Hamblen Hospital Association Hospital, Morristown, TN, CCN 440030
• Roane Medical Center Hospital, Harriman, TN, CCN 440031

Merit-based Incentive Payment System (MIPS)

Final score

79.28 of 100Reported as group

Quality

75.62

Improvement activities

40

Medicare fee-for-service enrollment

Enrolled in TN

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 2, 2026.

{
    "created_epoch": "1523145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1972000800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 LAUREL AVE # N304",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161810",
            "telephone_number": "865-766-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 LAUREL AVE # N304",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161810",
            "telephone_number": "865-766-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPOLO",
        "first_name": "JACOB",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-08",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TN",
            "license": "64086",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Knoxville, TN
• Vascular & Interventional Radiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; 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.