MISS JACLYNN J DO (M.D.) – Family Medicine Physician, NPI 1366439051
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,194 FAMILY PRACTICE in CA
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Provider Addresses for MISS JACLYNN J DO (M.D.)
10141, Westminster Avenue, Little Saigon Tourist Commercial District, Garden Grove, Orange County, California, 92843, United States
GARDEN GROVE, CA 928434790
Phone: (714) 467-4321
Fax: (714) 467-4311
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 31 Open Payments records for all available years, with a total value of $959.
Total Amount is formed as General ($959) + Research ($0) + Ownership ($0) = $959.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Amgen Inc. ($354).
Total Amount
$959
General + Research + Ownership
Payments
31
Total payment records
General Amount
$959
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Amgen Inc. | $354 |
| AstraZeneca Pharmaceuticals LP | $208 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $89 |
| Lilly USA, LLC | $65 |
| GlaxoSmithKline, LLC. | $52 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-12-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041208000822 | I | Family Practice | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 688 | 240 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 611 | 225 | $0 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic | 330 | 190 | $0 |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 322 | 185 | $0 |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 308 | 130 | $0 |
Insurance plans in this area (ZIP 92843)
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