JAYCOB NIETFELD (APRN) – Family Nurse Practitioner, NPI 1417544479

JAYCOB NIETFELD (APRN) is a healthcare provider. based in Long prairie, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 78211 (MN). The NPI Number for JAYCOB NIETFELD (APRN) is 1417544479

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
JAYCOB NIETFELD (APRN)
NPI
1417544479
Phone
(320) 732-2131
Address
50 CENTRACARE DR
Enumeration Date
24 December 2020
Last Update Date
24 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3207322141
Graduation Year
2020 (6 years ago)
PAC ID
6800200601
Group Practice PAC ID
3870524598
Professional Enrollment ID
I20210205000004
Address ID
MN563472100LO50XXXDRXX300
Telehealth
Yes

Contacts

Secure Messaging
jaycob.nietfeld@centracare.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness85
Years active:5State licenses:2Other namesUpdated within 12 months

5,748 NURSE PRACTITIONER in MN

Provider Addresses for JAYCOB NIETFELD (APRN)

  • 50 CENTRACARE DR

    LONG PRAIRIE, MN 563472100

    Phone: (320) 732-2131

    Mailing address matches the actual address.

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 $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2023-11-28 • Largest payer in this snapshot: PFIZER INC. ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-28

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
PFIZER INC.$16
View all Open Payments →|Open Payments Risk Radar →

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: 2021-02-05

PECOS data refreshed: 2026-06-15

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
I20210205000004INurse PractitionerMNTBD

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 56347)

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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: 3870524598View full group profile
NameSpecialtyState
General Surgery, Colorectal Surgery (Proctology), Surgical Oncology, Thoracic SurgeryMN
Physician AssistantGA
Family PracticeND
Hospice/Palliative CareMN
Internal Medicine, HospitalistMN
Nurse PractitionerMN
Nurse PractitionerMN
Internal Medicine, HospitalistMI
Internal Medicine, HospitalistMN
Internal Medicine, HospitalistMN

Reviews

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Frequently asked questions

Is there an official ID for JAYCOB NIETFELD (APRN) in U.S. healthcare records?
The official identifier for JAYCOB NIETFELD (APRN) is NPI 1417544479.
Is JAYCOB NIETFELD (APRN) still an active registrant?
JAYCOB NIETFELD (APRN) carries an active NPI according to the public dataset.
What area of care is associated with JAYCOB NIETFELD (APRN)?
JAYCOB NIETFELD (APRN)'s record emphasizes Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Minnesota is JAYCOB NIETFELD (APRN) registered?
Use Long Prairie, Minnesota as the headline location for JAYCOB NIETFELD (APRN) here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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