RACHAEL SUE JACOBY MD
NPI 1265659213
Ophthalmology in Salt Lake City, UT
About Rachael Sue Jacoby Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RACHAEL SUE JACOBY MD (NPI 1265659213) is an individual ophthalmology provider in Salt Lake City, Utah, licensed in Utah (5764061-1205) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS, is affiliated with Intermountain Medical Center, and is a graduate of Creighton University School Of Medicine (2004).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Rachael Sue Jacoby Md 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.
Medicare Billing Reassignments
3Medicare enrollment records show Rachael Jacoby reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Salt Lake City, UT 84132
- Reassigned Medicare billing, Utah enrollment
- 2,620 clinicians in this Medicare group
Salt Lake City, UT 84113
- Reassigned Medicare billing, Utah enrollment
- 751 clinicians in this Medicare group
Salt Lake City, UT 84107
- Reassigned Medicare billing, Utah enrollment
- 10 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 12
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.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Intermountain Medical Center
Acute Care Hospitals · Murray, UTHoly Cross Hospital-Davis
Acute Care Hospitals · Layton, UTSt Mark's Hospital
Acute Care Hospitals · Salt Lake City, UTPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84132 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Other Providers at the Same Location NPPES 19
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Rachael Jacoby's NPI number?
The NPI number for Rachael Jacoby is 1265659213. It was assigned to this individual provider in the NPPES registry on April 19, 2007.
Where is Rachael Jacoby located?
Rachael Jacoby practices at 65 Mario Capecchi Dr, Salt Lake City, UT 84132. The listed phone number is (801) 581-2352.
What is Rachael Jacoby's specialty?
The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.
Is Rachael Jacoby enrolled in Medicare?
Yes. Rachael Jacoby 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.
Which organizations bill Medicare for Rachael Jacoby's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Rachael Jacoby reassigns Medicare benefits to 3 organizations: University Of Utah Adult Services (Salt Lake City, UT), University Of Utah Pediatric Services (Salt Lake City, UT) and Retina Associates Of Utah, PLLC (Salt Lake City, UT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Rachael Jacoby's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Rachael Jacoby accept?
Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Rachael 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.
Is Rachael Jacoby affiliated with any hospitals?
According to CMS data, Rachael Jacoby is affiliated with Intermountain Medical Center, Holy Cross Hospital-Davis and St Mark's Hospital.
When was this NPI record last updated?
The NPPES record for Rachael Jacoby was last updated on October 21, 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.
# Rachael Sue Jacoby, MD · NPI 1265659213
Ophthalmology physician in Salt Lake City, Utah. Individual provider, active in the CMS NPPES registry since April 19, 2007.
## Identity
- **NPI:** 1265659213 (Entity type: Individual)
- **Enumerated:** April 19, 2007
- **Primary specialty:** Ophthalmology · taxonomy 207W00000X
- **State license:** 5764061-1205 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 65 MARIO CAPECCHI DR, Salt Lake City, UT 84132-0001
- **Phone:** (801) 581-2352
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): University Of Utah Adult Services (NPI 1033513957, Salt Lake City, UT); University Of Utah Pediatric Services (NPI 1023472594, Salt Lake City, UT); Retina Associates Of Utah, PLLC (NPI 1396867214, Salt Lake City, UT) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Creighton University School Of Medicine, class of 2004
## Record status
- **NPPES last updated:** October 21, 2021
- **Other identifiers:** Other 60966 (WI); Medicaid 1265659213 (WI)
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Source: [NPI Profile](https://npiprofile.com/npi/1265659213) · Data from the CMS NPPES public registry.