ELVIRE JACQUES (M.D.) – Maternal & Fetal Medicine Physician, NPI 1104840719
Maternal & Fetal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,538 OBSTETRICS/GYNECOLOGY in FL
Provider Addresses for ELVIRE JACQUES (M.D.)
PO BOX 744069 DEPT 50028
ATLANTA, GA 303844069
Phone: (954) 939-5000
Type: Mailing
2900 CORPORATE WAY
DOOR D
MIRAMAR, FL 330253925
Phone: (954) 276-5685
Fax: (954) 985-7074
Type: Mailing
4105 PEMBROKE RD
HOLLYWOOD, FL 330218103
Phone: (954) 265-3015
Type: Location
1951, Southwest 172nd Avenue, Miramar, Broward County, Florida, 33029, United States
STE 309
MIRAMAR, FL 330295593
Phone: (954) 499-4352
Fax: (954) 242-6600
Type: Location
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: 2005-08-22
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 |
|---|---|---|---|---|
| I20050822000417 | I | Obstetrics/Gynecology | 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 30384)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| Cardiac Surgery, Thoracic Surgery | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| Cardiovascular Disease (Cardiology) | FL | |
| - | FL | |
| Family Practice | CO |
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