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LIDIYA M JACOB APRN, CNP
NPI 1689294258
Nurse Practitioner in Palos Heights, IL

Active since April 23, 2020PECOS Enrolled
94.1/100
CMS Quality Rating
12251 S 80TH AVE, PALOS HEIGHTS, IL 60463(630) 257-1111(630) 257-1115 Get Directions Write a Review

NPPES record last updated: December 30, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 30, 2021, Apr 23, 2020 (2 updates tracked since 2020).

About Lidiya M Jacob Aprn, Cnp NPPES

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

LIDIYA M JACOB APRN, CNP (NPI 1689294258) is an individual nurse practitioner in Palos Heights, Illinois, licensed in Illinois (209021213) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Frankfort.

NPPES Registry Identity

NPI1689294258
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameLIDIYA M JACOBCredential: APRN, CNP
Location Address12251 S 80TH AVEPalos Heights, IL 60463-1290
Mailing Address12251 S 80th AvePalos Heights, IL 60463-1290 · (630) 257-1111 · Fax (630) 257-1115
Phone(630) 257-1111
Fax(630) 257-1115
Sole ProprietorNo
Enumeration DateApril 23, 2020
Last NPPES UpdateDecember 30, 20212 updates tracked since enumeration
NPPES CertifiedDecember 30, 2021
✔ NPI 1689294258 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in IL · 209021213
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
12251 S 80TH AVE, Palos Heights, IL 60463
Open in Google Maps ↗

Secondary Practice Location 1

Location 120635 Abbey Woods Ct N # SFrankfort, IL 60423-3181 · Phone (815) 464-9779

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lidiya M Jacob Aprn, Cnp 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.

Medicare Billing Reassignment

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

Central Dupage Physician Group
18 mi
Family Medicine
5777 DEPARTMENT
Carol Stream, IL 60122
  • Reassigned Medicare billing, Illinois enrollment
  • 1,664 clinicians in this Medicare group
NPI 1033149844 (630) 933-3300

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 4

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.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
739 services253 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
134 services81 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
69 services68 patients
Nursing facility discharge day management, 30 minutes or less 99315
Nursing facility discharge day management involves organizing your transition from the nursing facility to your home or another facility. This service, taking 30 minutes or less, includes finalizing medical instructions, arranging follow-up care, and answering any questions.
22 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60463 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

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.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.59
Promoting Interoperability100
Improvement Activities40

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.

Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches E2201
DME-Wheelchairs · category DD021N
1 supplier11 claims11 services$18.47 avg. paid by Medicare
Lightweight wheelchair K0003
DME-Wheelchairs · category DD000N
1 supplier14 claims14 services$22.54 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 20

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

MATTHEW SCOTT KOMINSKY MD
Anesthesiology
12251 S 80TH AVE
PALOS HEIGHTS, IL 60463
Cook County (708) 923-4000
NOOR BADER APRN, CRNA
Nurse Anesthetist, Certified Registered
12251 S 80TH AVE
PALOS HEIGHTS, IL 60463
Cook County (708) 923-3936
DR. JOSEPH C BREMER JR. M.D.
Emergency Medicine
12251 S 80TH AVE
PALOS HEIGHTS, IL 60463
Cook County (708) 923-5800
MARIKAY T GAZDA LCSW
Social Worker (Clinical)
12251 S 80TH AVE
PALOS HEIGHTS, IL 60463
Cook County (708) 923-4941
MICHAEL J BAUTISTA M.D.
Anesthesiology
12251 S 80TH AVE, PALOS COMMUNITY HOSPITAL
PALOS HEIGHTS, IL 60463
Cook County (708) 923-5700
VALERIE SAFFAR APRN, CNP
Nurse Practitioner
12251 S 80TH AVE
PALOS HEIGHTS, IL 60463
Cook County (708) 923-5869
WINSTON DANG MD
Hospitalist
12251 S 80TH AVE
PALOS HEIGHTS, IL 60463
Cook County (708) 923-4000
EMILY MACKANIN PT
Physical Therapist
12251 S 80TH AVE
PALOS HEIGHTS, IL 60463
Cook County (708) 923-3368

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 Lidiya Jacob's NPI number?

The NPI number for Lidiya Jacob is 1689294258. It was assigned to this individual provider in the NPPES registry on April 23, 2020.

Where is Lidiya Jacob located?

Lidiya Jacob practices at 12251 S 80th Ave, Palos Heights, IL 60463. The listed phone number is (630) 257-1111.

What is Lidiya Jacob's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Lidiya Jacob enrolled in Medicare?

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

Which organization bills Medicare for Lidiya Jacob's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lidiya Jacob reassigns Medicare benefits to Central Dupage Physician Group (Carol Stream, IL). 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 Lidiya Jacob'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 Lidiya Jacob was last updated on December 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.