Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Benjamin Clark Jacobs, MD

Individual provider Diagnostic Radiology Physician · NPI 1982846119

Benjamin Clark Jacobs, MD is a Diagnostic Radiology in Provo, Utah. Graduated from Washington University School of Medicine in 2009, 17 years ago. Practices with Revere Health PC, a 410-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
17
Trained at
Washington University School of Medicine
Licensed in
UT
In the registry since
2009
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1055 N 500 W Ste 112
Provo, UT 84604-3305
Phone: (801) 812-4624
Fax: (801) 812-4699
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 9693882-1205 (UT)

Record details

NPI number1982846119
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 2, 2009
Last updated in NPPESMarch 25, 2025
Certification dateMarch 25, 2025
Mailing address1055 N 500 W, Attn: Credentialing, Provo, UT 84604-3305

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolWASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 2009 (17 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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