JERIC AGNES (FNP-BC) – Adult Health Nurse Practitioner, NPI 1114532611
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for JERIC AGNES (FNP-BC)
3880 SALEM LAKE DR STE F
LONG GROVE, IL 600475292
Phone: (847) 719-2220
Fax: (847) 719-2265
Type: Mailing
7731 N HARLEM AVE
NILES, IL 607144730
Phone: (847) 877-3783
Type: Location
10 E 22ND ST STE 214
LOMBARD, IL 601486108
Phone: (888) 384-7769
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $81.
Total Amount is formed as General ($81) + Research ($0) + Ownership ($0) = $81.
Last reported payment date: 2023-09-09 • Largest payer in this snapshot: AngioDynamics, Inc. ($81).
Total Amount
$81
General + Research + Ownership
Payments
5
Total payment records
General Amount
$81
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AngioDynamics, Inc. | $81 |
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: 2022-09-21
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 |
|---|---|---|---|---|
| I20220921002205 | I | Nurse Practitioner | IL | 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 |
|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 646 | 107 | $0 |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 173 | 66 | $0 |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 75 | 48 | $0 |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 67 | 54 | $0 |
| 99497 | Advance care planning, first 30 minutes | 62 | 52 | $0 |
Insurance plans in this area (ZIP 60047)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | IL | |
| Internal Medicine | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Family Practice | IL | |
| Family Practice | IL | |
| Internal Medicine | IL | |
| Internal Medicine | IL | |
| Internal Medicine | IL | |
| - | IL |
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