JAY DECLARADOR – Nurse Practitioner, NPI 1417460502
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for JAY DECLARADOR
5450 ASTOR LN APT 418
ROLLING MEADOWS, IL 600084116
Phone: (847) 259-7173
Type: Mailing
Fontano's Pizza and Subs, 332, South Michigan Avenue, Printer's Row, Loop, Chicago, Cook County, Illinois, 60604, United States
CHICAGO, IL 606044434
Phone: (888) 660-4425
Type: Location
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 $99.
Total Amount is formed as General ($99) + Research ($0) + Ownership ($0) = $99.
Last reported payment date: 2024-03-06 • Largest payer in this snapshot: ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) ($99).
Total Amount
$99
General + Research + Ownership
Payments
1
Total payment records
General Amount
$99
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) | $99 |
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: 2018-01-16
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 |
|---|---|---|---|---|
| I20180116000439 | 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 |
|---|---|---|---|---|
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 707 | 58 | $0 |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 57 | 36 | $0 |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 53 | 52 | $0 |
Insurance plans in this area (ZIP 60008)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | IL |
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