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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACOB DANIEL HARTUNG MD
NPI 1649752171
Emergency Medicine - Pediatric Emergency Medicine in San Diego, CA

Active since August 31, 2018PECOS Enrolled
3020 CHILDRENS WAY # MC5124, SAN DIEGO, CA 92123(858) 966-6764 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 29, 2026, Mar 18, 2023, Apr 2, 2020 and 2 more (5 updates tracked since 2018).

About Jacob Daniel Hartung Md NPPES

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

JACOB DANIEL HARTUNG MD (NPI 1649752171) is an individual pediatric emergency medicine provider in San Diego, California, licensed in California (A187080) and active in the NPI registry since August 2018. He is enrolled in Medicare PECOS, maintains a secondary practice location in Sacramento, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1649752171
Entity TypeIndividualMale
Primary Taxonomy207PP0204X
Provider Legal NameJACOB DANIEL HARTUNGCredential: MD
Location Address3020 CHILDRENS WAY # MC5124San Diego, CA 92123-4223
Mailing AddressPo Box 255228Sacramento, CA 95865-5228 · (800) 470-0071 · Fax (916) 854-6769
Phone(858) 966-6764
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateAugust 31, 2018
Last NPPES UpdateSeptember 29, 20265 updates tracked since enumeration
NPPES CertifiedSeptember 29, 2026
✔ NPI 1649752171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency Medicine · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207PP0204X
License✔ Licensed in CA · A187080
Definition
Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department.
3020 CHILDRENS WAY # MC5124, San Diego, CA 92123
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Secondary Practice Location 1

Location 12825 Capitol AveSacramento, CA 95816-6039 · Phone (916) 887-2845 · Fax (916) 739-3251

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Daniel Hartung Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5799243580
PECOS Enrollment IDI20260821003029
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.

Medicare Billing Reassignment

Medicare enrollment records show Jacob Hartung reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sutter Valley Medical Foundation
398 mi
Multi-Specialty
600 COFFEE RD
Modesto, CA 95355
  • Reassigned Medicare billing, California enrollment
  • 3,056 clinicians in this Medicare group
NPI 1669846986 (209) 524-1211

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92123 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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.

Other Providers at the Same Location NPPES 20

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

EMILY BONTRAGER MD
Student in an Organized Health Care Education/Training Program
3020 CHILDRENS WAY # MC5124
SAN DIEGO, CA 92123
San Diego County (858) 966-6764
MARISSA CALDWELL
Student in an Organized Health Care Education/Training Program
3020 CHILDRENS WAY # MC5124
SAN DIEGO, CA 92123
San Diego County (858) 966-6764
DREW MATSUURA
Student in an Organized Health Care Education/Training Program
3020 CHILDRENS WAY # MC5124
SAN DIEGO, CA 92123
San Diego County (858) 966-6764
KALEY ANN GROOMS MD
Student in an Organized Health Care Education/Training Program
3020 CHILDRENS WAY # MC5124
SAN DIEGO, CA 92123
San Diego County (585) 626-0782
MARC ALAIN DUROCHER MD
Pediatrics
3020 CHILDRENS WAY # MC5124
SAN DIEGO, CA 92123
San Diego County (858) 966-6764
LAUREN NICOLE ARONSON
Student in an Organized Health Care Education/Training Program
3020 CHILDRENS WAY # MC5124
SAN DIEGO, CA 92123
San Diego County (858) 966-6764
BRANDON BRIZUELA
Student in an Organized Health Care Education/Training Program
3020 CHILDRENS WAY # MC5124
SAN DIEGO, CA 92123
San Diego County (858) 966-6764
JESSICA TRAVIS MD
Pediatrics
3020 CHILDRENS WAY # MC5124
SAN DIEGO, CA 92123
San Diego County (858) 966-6764

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 Jacob Hartung's NPI number?

The NPI number for Jacob Hartung is 1649752171. It was assigned to this individual provider in the NPPES registry on August 31, 2018.

Where is Jacob Hartung located?

Jacob Hartung practices at 3020 Childrens Way # Mc5124, San Diego, CA 92123. The listed phone number is (858) 966-6764.

What is Jacob Hartung's specialty?

The primary specialty registered for this NPI is Emergency Medicine, specializing in Pediatric Emergency Medicine, with taxonomy code 207PP0204X.

Is Jacob Hartung enrolled in Medicare?

Yes. Jacob Hartung is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacob Hartung's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Hartung reassigns Medicare benefits to Sutter Valley Medical Foundation (Modesto, CA). The 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 Jacob Hartung's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jacob Hartung was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days 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.