NICOLE ANN JAFFE (PH.D.) – Clinical Psychologist, NPI 1649051194

NICOLE ANN JAFFE (PH.D.) is a healthcare provider. based in Fort myers, Florida. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PY12063 (FL). The NPI Number for NICOLE ANN JAFFE (PH.D.) is 1649051194

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE ANN JAFFE (PH.D.)
NPI
1649051194
Phone
(239) 278-3443
Address
12499 BRANTLEY COMMONS CT STE 101
Enumeration Date
11 October 2023
Last Update Date
11 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2392783443
Graduation Year
2021 (5 years ago)
PAC ID
2365891371
Group Practice PAC ID
0840287991
Professional Enrollment ID
I20231214003902
Address ID
FL339075694FO12499CTXX402
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

1,602 CLINICAL PSYCHOLOGIST in FL

Provider Addresses for NICOLE ANN JAFFE (PH.D.)

  • 12499 BRANTLEY COMMONS CT STE 101

    FORT MYERS, FL 339075694

    Phone: (239) 278-3443

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2023-12-14

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231214003902IClinical PsychologistFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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 33907)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0840287991View full group profile
NameSpecialtyState
Clinical PsychologistPA
Clinical PsychologistFL
Clinical PsychologistPA
Clinical PsychologistFL
Clinical PsychologistFL
Clinical PsychologistFL
Clinical PsychologistFL

Reviews

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Frequently asked questions

How do payers reference NICOLE ANN JAFFE (PH.D.)?
For NICOLE ANN JAFFE (PH.D.), use NPI 1649051194 as the unique 10-digit identifier.
Is NICOLE ANN JAFFE (PH.D.) shown as active in public data?
Registry records indicate NICOLE ANN JAFFE (PH.D.) maintains an active NPI.
What kind of doctor is NICOLE ANN JAFFE (PH.D.)?
NICOLE ANN JAFFE (PH.D.) is associated with Clinical Psychologist in the directory — Clinical services aligned with this taxonomy classification.
Is NICOLE ANN JAFFE (PH.D.) located near Fort Myers?
NICOLE ANN JAFFE (PH.D.) currently maps to Fort Myers, Florida in this extract.
Does NICOLE ANN JAFFE (PH.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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