JACLYN K TAVERNA (FNP-BC, MSN) – Nurse Practitioner, NPI 1164675179
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
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Provider Addresses for JACLYN K TAVERNA (FNP-BC, MSN)
PO BOX 458
YORKVILLE, IL 605600458
Phone: (630) 385-2360
Fax: (630) 385-2934
Type: Mailing
50 S B B KING BLVD
MEMPHIS, TN 381032626
Phone: (901) 436-1381
Type: Mailing
East Kendall Drive, Countryside Center, Yorkville, Bristol Township, Kendall County, Illinois, 60560, United States
YORKVILLE, IL 605601956
Phone: (630) 385-2360
Fax: (630) 385-2934
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $166.
Total Amount is formed as General ($166) + Research ($0) + Ownership ($0) = $166.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($60).
Total Amount
$166
General + Research + Ownership
Payments
8
Total payment records
General Amount
$166
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2009-02-04
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 |
|---|---|---|---|---|
| I20090204000334 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60560)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IL | |
| Mental Health Counselor | IL | |
| Mental Health Counselor | IL |
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