KYLIE HARTIGAN JACOBSEN OD
NPI 1891206819
Optometrist in Elk River, MN
About Kylie Hartigan Jacobsen Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KYLIE HARTIGAN JACOBSEN OD (NPI 1891206819) is an individual optometrist in Elk River, Minnesota, licensed in Minnesota (3537) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses
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
Kylie Hartigan Jacobsen Od 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 Kylie Jacobsen reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Elk River, MN 55330
- Reassigned Medicare billing, Minnesota enrollment
- 14 clinicians in this Medicare group
Monticello, MN 55362
- Reassigned Medicare billing, Minnesota enrollment
- 6 clinicians in this Medicare group
Saint Cloud, MN 56301
- Reassigned Medicare billing, Minnesota enrollment
- 7 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 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55330 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 7
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 Kylie Jacobsen's NPI number?
The NPI number for Kylie Jacobsen is 1891206819. It was assigned to this individual provider in the NPPES registry on October 17, 2017.
Where is Kylie Jacobsen located?
Kylie Jacobsen practices at 19576 Holt St NW, Elk River, MN 55330. The listed phone number is (763) 241-2083.
What is Kylie Jacobsen's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Kylie Jacobsen enrolled in Medicare?
Yes. Kylie 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.
Which organizations bill Medicare for Kylie Jacobsen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kylie Jacobsen reassigns Medicare benefits to 3 organizations: Minnesota Optical LLC (Elk River, MN), Elaine Happ Od PA (Monticello, MN) and Mlp Optometry Ltd (Saint Cloud, MN). 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 Kylie Jacobsen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kylie Jacobsen accept?
Health plans from Providence Health Plan list Kylie 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 Kylie Jacobsen was last updated on October 17, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Kylie Hartigan Jacobsen, OD · NPI 1891206819
Optometrist provider in Elk River, Minnesota. Individual provider, active in the CMS NPPES registry since October 17, 2017.
## Identity
- **NPI:** 1891206819 (Entity type: Individual)
- **Enumerated:** October 17, 2017
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 3537 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 19576 HOLT ST NW, Elk River, MN 55330-1287
- **Phone:** (763) 241-2083 · **Fax:** (763) 241-2083
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Minnesota Optical LLC (NPI 1831303437, Elk River, MN); Elaine Happ Od PA (NPI 1033281597, Monticello, MN); Mlp Optometry Ltd (NPI 1801454608, Saint Cloud, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** October 17, 2017
---
Source: [NPI Profile](https://npiprofile.com/npi/1891206819) · Data from the CMS NPPES public registry.