KYLIE HARTIGAN JACOBSEN OD
NPI 1891206819
Optometrist in Elk River, MN

Q: 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.

Q: What is Kylie Jacobsen's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: 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 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.

Active since October 17, 2017PECOS EnrolledAccepts Medicare Assignment

19576 HOLT ST NW, ELK RIVER, MN 55330(763) 241-2083(763) 241-2083 Get Directions Write a Review

NPPES record last updated: October 17, 2017. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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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

NPI1891206819

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameKYLIE HARTIGAN JACOBSENCredential: OD

Location Address19576 HOLT ST NWElk River, MN 55330-1287

Mailing Address19576 Holt St NwElk River, MN 55330-1287 · (763) 241-2083

Phone(763) 241-2083

Fax(763) 241-2083

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateOctober 17, 2017

✔ NPI 1891206819 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in MN · 3537

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

19576 HOLT ST NW, Elk River, MN 55330

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

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.

PECOS PAC ID4789941147

PECOS Enrollment IDI20171120003687

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.

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.

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

78 services77 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

61 services46 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

37 services34 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

36 services24 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

19 services17 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

17 services17 patients

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.

New Patient

$127.61 typical visit price

range $56.00 – $168.28

Typical copayment $31.90 (range $14.00 – $42.07)

Most-billed visit code 99204

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

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 7

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

DR. ELIZABETH MAY MOSLEY O.D.

Optometrist