NICOLE ANNETTE CLARKE JAGODOWSKI – Pediatric Nurse Practitioner, NPI 1033507868

NICOLE ANNETTE CLARKE JAGODOWSKI is a healthcare provider. based in Boston, Massachusetts. specializing in NURSE PRACTITIONER. They hold a License No. 2284312 (MA). The NPI Number for NICOLE ANNETTE CLARKE JAGODOWSKI is 1033507868

Main info

Female
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE ANNETTE CLARKE JAGODOWSKI
NPI
1033507868
Phone
(978) 821-1723
Address
147 MILK ST
Enumeration Date
1 January 2015
Last Update Date
5 April 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7812212500
Graduation Year
2014 (12 years ago)
PAC ID
1759645047
Group Practice PAC ID
4789588641
Professional Enrollment ID
I20180515000672
Address ID
MA018034758BU20XXXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

8,972 NURSE PRACTITIONER in MA

Provider Addresses for NICOLE ANNETTE CLARKE JAGODOWSKI

  • 147 MILK ST

    BOSTON, MA 021094806

    Phone: (978) 821-1723

    Type: Mailing

  • 20 WALL ST

    BURLINGTON, MA 018034758

    Phone: (781) 221-2800

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2018-05-15

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180515000672INurse PractitionerMATBD

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.

Verify on CMS Revalidation Lookup Tool

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 02109)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789588641View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to NICOLE ANNETTE CLARKE JAGODOWSKI?
NPI 1033507868 is assigned to NICOLE ANNETTE CLARKE JAGODOWSKI under the national enumeration system.
Is NICOLE ANNETTE CLARKE JAGODOWSKI's NPI currently valid?
The extract we use shows NICOLE ANNETTE CLARKE JAGODOWSKI as active.
Can you summarize NICOLE ANNETTE CLARKE JAGODOWSKI's specialty in plain language?
Clinically, the directory lists NICOLE ANNETTE CLARKE JAGODOWSKI with Pediatric Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does NICOLE ANNETTE CLARKE JAGODOWSKI practice in Massachusetts?
You will see Boston, Massachusetts on file for NICOLE ANNETTE CLARKE JAGODOWSKI alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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