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DR. DAVID A JACOBY DOCTOR OF OPTOMETRY
NPI 1003811761
Optometrist in Osage City, KS

Active since June 17, 2005PECOS Enrolled
131 W MARKET ST STE A, OSAGE CITY, KS 66523(785) 528-4136(785) 528-3422 Get Directions Write a Review

NPPES record last updated: February 23, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 23, 2023, Oct 27, 2022, Sep 28, 2021 (3 updates tracked since 2021).

About Dr. David A Jacoby Doctor Of Optometry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DAVID A JACOBY DOCTOR OF OPTOMETRY (NPI 1003811761) is an individual optometrist in Osage City, Kansas, licensed in Kansas (1171-3) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003811761
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. DAVID A JACOBYCredential: DOCTOR OF OPTOMETRY
Location Address131 W MARKET ST STE AOsage City, KS 66523-1099
Mailing AddressPo Box 258Osage City, KS 66523-0258 · (785) 528-4136 · Fax (785) 528-3422
Phone(785) 528-4136
Fax(785) 528-3422
Sole ProprietorNo
Enumeration DateJune 17, 2005
Last NPPES UpdateFebruary 23, 20233 updates tracked since enumeration
NPPES CertifiedFebruary 23, 2023
✔ NPI 1003811761 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in KS · 1171-3
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
131 W MARKET ST STE A, Osage City, KS 66523
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Other Identifiers 1

Medicaid1003811761KS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. David A Jacoby Doctor Of Optometry is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
91 services91 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
39 services28 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
21 services21 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
12 services12 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 66523 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.41 typical visit price
range $53.00 – $161.67
Typical copayment $30.60 (range $13.25 – $40.41)
Most-billed visit code 99204
Established Patient
$66.40 typical visit price
range $16.88 – $132.11
Typical copayment $16.60 (range $4.22 – $33.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%40 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier21 claims21 services$41.77 avg. paid by Medicare
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens V2303
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier21 claims38 services$39.54 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID A JACOBY OD CHARTERED
Eyewear Supplier
131 W MARKET ST STE A
OSAGE CITY, KS 66523
Osage County (785) 528-4136

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is David Jacoby's NPI number?

The NPI number for David Jacoby is 1003811761. It was assigned to this individual provider in the NPPES registry on June 17, 2005.

Where is David Jacoby located?

David Jacoby practices at 131 W Market St Ste A, Osage City, KS 66523. The listed phone number is (785) 528-4136.

What is David Jacoby's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is David Jacoby enrolled in Medicare?

Yes. David Jacoby is registered in the Medicare PECOS enrollment system.

What insurance does David Jacoby accept?

Health plans from Blue Cross and Blue Shield of Kansas, Inc. list David Jacoby as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for David Jacoby was last updated on February 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.