JACOB ANDREW BOEHME OD
NPI 1942801907
Optometrist - Pediatrics in Memphis, TN

Q: What is Jacob Boehme's NPI number?

The NPI number for Jacob Boehme is 1942801907. It was assigned to this individual provider in the NPPES registry on November 5, 2020.

Q: What is Jacob Boehme's specialty?

The primary specialty registered for this NPI is Optometrist, specializing in Pediatrics, with taxonomy code 152WP0200X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Boehme was last updated on December 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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 November 05, 2020PECOS EnrolledAccepts Medicare Assignment

1245 MADISON AVE, MEMPHIS, TN 38104(901) 722-3200 Get Directions Write a Review

NPPES record last updated: December 31, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Dec 31, 2025, Mar 26, 2021, Nov 5, 2020 (3 updates tracked since 2020).

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About Jacob Andrew Boehme Od NPPES

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

JACOB ANDREW BOEHME OD (NPI 1942801907) is an individual pediatrics provider in Memphis, Tennessee, licensed in Tennessee (3656) and active in the NPI registry since November 2020. He is enrolled in Medicare PECOS, is affiliated with University Of Iowa Hospital & Clinics, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1942801907

Entity TypeIndividualMale

Primary Taxonomy152WP0200X

Provider Legal NameJACOB ANDREW BOEHMECredential: OD

Location Address1245 MADISON AVEMemphis, TN 38104-2211

Mailing Address1245 Madison AveMemphis, TN 38104-2211 · (901) 722-3250 · Fax (901) 722-3388

Phone(901) 722-3200

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateNovember 5, 2020

Last NPPES UpdateDecember 31, 20253 updates tracked since enumeration

NPPES CertifiedDecember 31, 2025

✔ NPI 1942801907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOptometrist · PediatricsEye and Vision Services Providers

Taxonomy Code152WP0200X

Licenses✔ Licensed in TN · 3656✔ Licensed in IA · 114718

Definition

Optometrists who work in Pediatrics are concerned with the prevention, development, diagnosis, and treatment of visual problems in children.

Also ListedOptometristTaxonomy 152W00000X · License 3656 (TN), 114718 (IA)

1245 MADISON AVE, Memphis, TN 38104

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Secondary Practice Locations 2

Location 1105 E 9th StCoralville, IA 52241-2209 · Phone (319) 467-2000

Location 2200 Hawkins DrIowa City, IA 52242-1009 · Phone (319) 356-3705 · Fax (319) 353-6030

Other Identifiers 1

MedicaidQ063630TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.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

Jacob Andrew Boehme 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 ID3375955412

PECOS Enrollment IDI20260105000385

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Iowa Hospital & Clinics

Acute Care Hospitals · Iowa City, IA

3/5 CMS rating

OwnershipGovernment - State

CMS Certification Number160058

Location200 Hawkins DriveIowa City, IA 52242 · Johnson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38104 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

$121.80 typical visit price

range $52.64 – $160.89

Typical copayment $30.45 (range $13.16 – $40.22)

Most-billed visit code 99204

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

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 20

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

DR. AZALIA ROCHELLE ROACH OD

Optometrist