MRS. JACLYN KIMBERLY FORAKER (FNP-C) – Family Nurse Practitioner, NPI 1073139465
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,869 NURSE PRACTITIONER in ME
Provider Addresses for MRS. JACLYN KIMBERLY FORAKER (FNP-C)
360 Broadway
Bangor, ME 044013979
Phone: (207) 907-1155
Fax: (207) 907-1888
Type: Location
195 Fore River Pkwy
Portland, ME 041022780
Phone: (207) 879-3466
Fax: (207) 879-3066
Type: Location
32 Resort Way
Ellsworth, ME 046051717
Phone: (844) 975-4584
Type: Location
885 Union St Ste 215
Bangor, ME 044013092
Phone: (207) 973-7380
Type: Location
885 UNION ST STE 215
BANGOR, ME 044013092
Phone: (207) 973-7380
Type: Mailing
10 Washington St
Waterville, ME 049014315
Phone: (207) 861-5731
Fax: (207) 275-4897
Type: Location
19 North St
Presque Isle, ME 047692240
Phone: (207) 768-4568
Fax: (207) 764-6459
Type: Location
125 Main St
Pittsfield, ME 049674364
Phone: (207) 487-3726
Type: Location
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT
PO BOX 7291
LEWISTON, ME 042437291
Phone: (207) 777-8941
Fax: (207) 777-8800
Type: Mailing
360 BROADWAY
BANGOR, ME 044013979
Phone: (207) 907-1155
Fax: (207) 907-1888
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $921.
Total Amount is formed as General ($921) + Research ($0) + Ownership ($0) = $921.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($527).
Total Amount
$921
General + Research + Ownership
Payments
11
Total payment records
General Amount
$921
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $527 |
| Inspire Medical Systems, Inc. | $221 |
| GlaxoSmithKline, LLC. | $173 |
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: 2021-08-16
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 |
|---|---|---|---|---|
| I20210816000230 | I | Nurse Practitioner | ME | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 204 | 173 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 103 | 81 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 25 | 25 | $0 |
| 99406 | Smoking and tobacco use intensive counseling, 4-10 minutes | 25 | 19 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 23 | 23 | $0 |
Insurance plans in this area (ZIP 04401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | NY | |
| Internal Medicine | ME | |
| Family Practice | ME | |
| G A S T R O E N T E R O L O G Y | ME | |
| Internal Medicine | ME | |
| G A S T R O E N T E R O L O G Y | ME | |
| Physician Assistant | ME | |
| Pulmonary Disease, Critical Care (Intensivists) | ME | |
| Orthopedic Surgery | NY | |
| Certified Registered Nurse Anesthetist (Crna) | ME |
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