AGATHA JEFFERSON (FNP) – Nurse Practitioner, NPI 1083967624
Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for AGATHA JEFFERSON (FNP)
1825 WILLOW RD
NORTHFIELD, IL 600932925
Phone: (847) 825-4515
Fax: (847) 825-4515
Type: Location
800 DEVON AVE
PARK RIDGE, IL 600684760
Phone: (847) 825-4515
Fax: (847) 825-4515
Type: Mailing
29373 NETWORK PL
CHICAGO, IL 606731293
Phone: (847) 390-5900
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 $64.
Total Amount is formed as General ($64) + Research ($0) + Ownership ($0) = $64.
Last reported payment date: 2023-06-22 • Largest payer in this snapshot: ACADIA Pharmaceuticals Inc ($64).
Total Amount
$64
General + Research + Ownership
Payments
1
Total payment records
General Amount
$64
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ACADIA Pharmaceuticals Inc | $64 |
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: 2013-07-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-07-31 (1044 days ago).
Enrollment records
1
Earliest due date
2023-07-31
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 |
|---|---|---|---|---|
| I20130711000880 | I | Nurse Practitioner | IL | 2023-07-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 31 | 30 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 18 | 18 | $0 |
Insurance plans in this area (ZIP 60093)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nephrology, Internal Medicine | IL | |
| A N E S T H E S I O L O G Y | IL | |
| - | MN | |
| - | IL | |
| - | IL | |
| Rheumatology, Internal Medicine | IL | |
| - | IL | |
| Internal Medicine | IL | |
| P S Y C H I A T R Y | IL | |
| - | IL |
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