MRS. JACKLYN HAGG (AGACNP) – Nurse Practitioner, NPI 1861928111
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,802 NURSE PRACTITIONER in ID
Provider Addresses for MRS. JACKLYN HAGG (AGACNP)
3100 CHANNING WAY
IDAHO FALLS, ID 834047533
Phone: (208) 529-6111
Fax: (208) 529-7021
Type: Location
3261, Northwest Mount Vintage Way, Silverdale, Kitsap County, Washington, 98383, United States
SUITE 221
SILVERDALE, WA 983836039
Phone: (360) 479-1952
Type: Mailing
PO BOX 277381
ATLANTA, GA 303847381
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $97.
Total Amount is formed as General ($97) + Research ($0) + Ownership ($0) = $97.
Last reported payment date: 2024-05-08 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($97).
Total Amount
$97
General + Research + Ownership
Payments
1
Total payment records
General Amount
$97
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Edwards Lifesciences Corporation | $97 |
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: 2021-09-23
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 |
|---|---|---|---|---|
| I20210923001103 | I | Nurse Practitioner | ID | 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 |
|---|---|---|---|---|
| 99291 | Critical care, first 30-74 minutes | 108 | 65 | $0 |
| 99292 | Critical care, each additional 30 minutes | 24 | 16 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 20 | 18 | $0 |
Insurance plans in this area (ZIP 83404)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | VT | |
| Internal Medicine | NY | |
| Pulmonary Disease, Internal Medicine | OK | |
| - | SC | |
| - | VA | |
| Pulmonary Disease, Critical Care (Intensivists) | GA | |
| Internal Medicine, Critical Care (Intensivists) | OR | |
| - | FL | |
| Internal Medicine | FL | |
| - | TN |
Reviews
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