TAMARA JACKMAN – Advanced Practice Midwife, NPI 1053371872

TAMARA JACKMAN is a healthcare provider. based in Minneapolis, Minnesota. specializing in CERTIFIED NURSE MIDWIFE (CNM). They hold a License No. 164100-2 (MN). The NPI Number for TAMARA JACKMAN is 1053371872

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
TAMARA JACKMAN
NPI
1053371872
Phone
Not provided
Address
3023 44TH AVE S
Enumeration Date
24 March 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6516027500
Graduation Year
2003 (23 years ago)
PAC ID
3476550310
Group Practice PAC ID
2062306434
Professional Enrollment ID
I20061107000055
Address ID
MN551072226SA153XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

251 CERTIFIED NURSE MIDWIFE (CNM) in MN

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Provider Addresses for TAMARA JACKMAN

  • 3023, 44th Avenue South, Cooper, Longfellow, Minneapolis, Hennepin County, Minnesota, 55406, United States

    MINNEAPOLIS, MN 554062311

    Phone:

    Type: Mailing

  • 153, Cesar Chavez Street, Saint Paul, Ramsey County, Minnesota, 55107, United States

    SAINT PAUL, MN 551072226

    Phone: (651) 222-1816

    Fax: (651) 602-7517

    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: 2006-11-07

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
I20061107000055ICertified Nurse Midwife (Cnm)MNTBD

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 55406)

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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: 2062306434View full group profile
NameSpecialtyState
Physician AssistantMN
Certified Nurse Midwife (Cnm)MN
Mental Health CounselorMN
Certified Nurse Midwife (Cnm)MN
Physician AssistantMN
-NJ
Family PracticeMN
Clinical Social WorkerFL
Nurse PractitionerMN
-MN

Reviews

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Frequently asked questions

What unique ID ties claims to TAMARA JACKMAN?
NPI 1053371872 is assigned to TAMARA JACKMAN under the national enumeration system.
Is TAMARA JACKMAN's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does TAMARA JACKMAN list a primary specialty?
If you are matching referrals, note Advanced Practice Midwife for TAMARA JACKMAN. Clinical services aligned with this taxonomy classification.
What location metadata exists for TAMARA JACKMAN?
The page summarizes Minneapolis, Minnesota for TAMARA JACKMAN; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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