JACLYN ELIZABETH LACKEY (FNP-BC) – Family Nurse Practitioner, NPI 1497058168
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,515 NURSE PRACTITIONER in NJ
Provider Addresses for JACLYN ELIZABETH LACKEY (FNP-BC)
1910 HWY 35
OAKHURST, NJ 077552715
Phone: (732) 531-4747
Type: Mailing
300 2nd Ave
Suite W217
Long Branch, NJ 077406303
Phone: (732) 923-6696
Fax: (732) 923-6626
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: 2025-06-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 8 Medicare enrollment records; no due dates published yet.
Enrollment records
8
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 |
|---|---|---|---|---|
| I20110419000787 | I | Nurse Practitioner | NJ | TBD |
| I20210810001505 | I | Nurse Practitioner | KS | TBD |
| I20221228000883 | I | Nurse Practitioner | IN | TBD |
| I20230106001060 | I | Nurse Practitioner | TN | TBD |
| I20230109002292 | I | Nurse Practitioner | MI | TBD |
| I20230309000121 | I | Nurse Practitioner | FL | TBD |
| I20250326000628 | I | Nurse Practitioner | KY | TBD |
| I20250604002826 | I | Nurse Practitioner | MD | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 07755)
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