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DR. DEREK P. JACOBSEN
NPI 1124462593
Optometrist in Sun City West, AZ

Active since April 29, 2013PECOS EnrolledAccepts Medicare Assignment
13613 W CAMINO DEL SOL STE 2, SUN CITY WEST, AZ 85375(623) 584-2100(623) 584-0023 Get Directions Write a Review

NPPES record last updated: March 1, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Derek P. Jacobsen NPPES

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

DR. DEREK P. JACOBSEN (NPI 1124462593) is an individual optometrist in Sun City West, Arizona, licensed in Arizona (1933) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1124462593
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. DEREK P. JACOBSEN
Location Address13613 W CAMINO DEL SOL STE 2Sun City West, AZ 85375-4480
Mailing Address14269 N 87th St Ste 203Scottsdale, AZ 85260-3695 · (480) 483-8882 · Fax (480) 419-5401
Phone(623) 584-2100
Fax(623) 584-0023
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateApril 29, 2013
Last NPPES UpdateMarch 1, 2021
NPPES CertifiedMarch 1, 2021
✔ NPI 1124462593 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 AZ · 1933
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.
13613 W CAMINO DEL SOL STE 2, Sun City West, AZ 85375
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Secondary Practice Locations 2

Location 17727 W Deer Valley Rd Ste E200Peoria, AZ 85382-2114 · Phone (623) 376-9070
Location 218325 N Allied Way, Suite 100Phoenix, AZ 85054-3105 · Phone (602) 467-4966 · Fax (480) 419-5401

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Derek P. Jacobsen is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3274759824
PECOS Enrollment IDI20141002002166
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 8

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.
270 services260 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
140 services139 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).
92 services89 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
91 services77 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.
84 services84 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
65 services56 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85375 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
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
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.

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 Derek Jacobsen's NPI number?

The NPI number for Derek Jacobsen is 1124462593. It was assigned to this individual provider in the NPPES registry on April 29, 2013.

Where is Derek Jacobsen located?

Derek Jacobsen practices at 13613 W Camino Del Sol Ste 2, Sun City West, AZ 85375. The listed phone number is (623) 584-2100.

What is Derek Jacobsen's specialty?

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

Is Derek Jacobsen enrolled in Medicare?

Yes. Derek Jacobsen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Derek Jacobsen accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Montana and 6 other insurers list Derek Jacobsen 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 Derek Jacobsen was last updated on March 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.