JACOB JOSEPH WARDACH (APRN) – Nurse Practitioner, NPI 1265083018
Nurse Practitioner
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
887 NURSE PRACTITIONER in HI
Provider Addresses for JACOB JOSEPH WARDACH (APRN)
81 MAKAWAO AVE #100
MAKAWAO, HI 96768
Phone: (808) 573-8900
Type: Location
Makawao Avenue, Makawao, Maui County, Hawaii, 96768, United States
STE 100
MAKAWAO, HI 967688859
Phone: (808) 573-8900
Fax: (808) 573-7505
Type: Mailing
6135 Cressy St
Indian River, MI 497495151
Phone: (231) 328-8908
Type: Location
5 CORNERSTONE SQ STE 100
WESTFORD, MA 018861483
Phone: (978) 692-1400
Fax: (978) 692-5995
Type: Mailing
PO BOX 655
ALPENA, MI 497070655
Phone: (231) 348-9900
Fax: (989) 358-3780
Type: Mailing
3434 M 119 STE C
HARBOR SPRINGS, MI 497409373
Phone: (231) 348-9900
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $74.
Total Amount is formed as General ($74) + Research ($0) + Ownership ($0) = $74.
Last reported payment date: 2024-12-02 • Largest payer in this snapshot: Indivior Inc. ($27).
Total Amount
$74
General + Research + Ownership
Payments
3
Total payment records
General Amount
$74
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Indivior Inc. | $27 |
| Supernus Pharmaceuticals, Inc. | $26 |
| AstraZeneca Pharmaceuticals LP | $20 |
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: 2023-12-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20191217003351 | I | Nurse Practitioner | HI | TBD |
| I20220407001858 | I | Nurse Practitioner | MA | TBD |
| I20231213002053 | I | Nurse Practitioner | MI | 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 96768)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Physician Assistant | MI | |
| - | MI | |
| - | MI | |
| Family Practice | MI | |
| Nurse Practitioner | MI | |
| General Practice | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI |
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