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JONATHAN T. JACOBS M.D.
NPI 1164458907
Internal Medicine in Overland Park, KS

Active since June 23, 2006Opted out of Medicare · through Jul 9, 2027CLIA 17D2200167 · Waiver
5701 W 119TH ST STE 419, OVERLAND PARK, KS 66209(913) 498-1444(913) 667-2759 Get Directions Write a Review

NPPES record last updated: October 26, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 26, 2017, Nov 7, 2016 (2 updates tracked since 2016).

About Jonathan T. Jacobs M.d. NPPES

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

JONATHAN T. JACOBS M.D. (NPI 1164458907) is an individual internal medicine provider in Overland Park, Kansas, licensed in Kansas (0429916) and active in the NPI registry since June 2006. He has opted out of Medicare through July 9, 2027 and remains eligible to order and refer and holds a CLIA Waiver certificate valid through November 12, 2026.

NPPES Registry Identity

NPI1164458907
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJONATHAN T. JACOBSCredential: M.D.
Location Address5701 W 119TH ST STE 419Overland Park, KS 66209-3721
Mailing Address5701 W 119th St Ste 419Overland Park, KS 66209-3721 · (913) 498-1444 · Fax (913) 667-2759
Phone(913) 498-1444
Fax(913) 667-2759
Sole ProprietorYes
Enumeration DateJune 23, 2006
Last NPPES UpdateOctober 26, 20172 updates tracked since enumeration
✔ NPI 1164458907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in KS · 0429916✔ Licensed in KS · 04-29916✔ Licensed in MO · 2002028986
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedPediatricsTaxonomy 208000000X · License 04-29916 (KS), 2002028986 (MO)
Also ListedHospitalistTaxonomy 208M00000X · License 2002028986 (MO), 0429916 (KS)
5701 W 119TH ST STE 419, Overland Park, KS 66209
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Jonathan T. Jacobs M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 9, 2017 through July 9, 2027.

Opt-Out Effective DateJuly 9, 2017
Opt-Out In Effect ThroughJuly 9, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 17D2200167

Jonathan Jacobs, MD, LLC · Overland Park, KS
Active · expires Nov 12, 2026
CLIA Number17D2200167
Laboratory TypePhysician Office
Certificate Effective DateNovember 13, 2024
Certificate Expiration DateNovember 12, 2026
Laboratory DirectorJonathan Jacobs
Laboratory Phone(913) 498-1444
Laboratory LocationJonathan Jacobs, MD, LLC5701 West 119 Street, Suite 240, Overland Park, KS 66209
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 66209 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
$94.12 typical visit price
range $16.88 – $132.11
Typical copayment $23.53 (range $4.22 – $33.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 8

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

Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
6 suppliers11 claims11 services$14.29 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
5 suppliers14 claims14 services$8.96 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
7 suppliers14 claims75 services$1.61 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers20 claims20 services$5.84 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
4 suppliers32 claims35 services$27.65 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers24 claims24 services$61.20 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Jonathan Jacobs's NPI number?

The NPI number for Jonathan Jacobs is 1164458907. It was assigned to this individual provider in the NPPES registry on June 23, 2006.

Where is Jonathan Jacobs located?

Jonathan Jacobs practices at 5701 W 119th St Ste 419, Overland Park, KS 66209. The listed phone number is (913) 498-1444.

What is Jonathan Jacobs's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jonathan Jacobs enrolled in Medicare?

No. Jonathan Jacobs has opted out of Medicare through July 9, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Does Jonathan Jacobs hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 17D2200167) is associated with this NPI, valid through November 12, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jonathan Jacobs was last updated on October 26, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.