JACQUELYN JANIS JACOBS (AGACNP-BC) – Acute Care Nurse Practitioner, NPI 1114773397
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for JACQUELYN JANIS JACOBS (AGACNP-BC)
2500 STATE ROAD 44 UNIT 12201
NEW SMYRNA BEACH, FL 321688282
Phone: (850) 879-2628
Type: Mailing
1300 MEDICAL DR
TALLAHASSEE, FL 323084646
Phone: (850) 879-2628
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $152.
Total Amount is formed as General ($152) + Research ($0) + Ownership ($0) = $152.
Last reported payment date: 2024-08-22 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($123).
Total Amount
$152
General + Research + Ownership
Payments
2
Total payment records
General Amount
$152
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $123 |
| Kiniksa Pharmaceuticals International, plc | $28 |
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: 2024-07-27
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 |
|---|---|---|---|---|
| I20240727000098 | I | Nurse Practitioner | FL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32168)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| R H E U M A T O L O G Y | KY | |
| Cardiovascular Disease (Cardiology), Internal Medicine | FL | |
| Physician Assistant | FL | |
| E N D O C R I N O L O G Y | MN | |
| - | FL | |
| Internal Medicine | FL | |
| - | IA | |
| Physician Assistant | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | OH |
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