JESSICA JACQUELINE GILLIS (CRNP) – Family Nurse Practitioner, NPI 1053760637

JESSICA JACQUELINE GILLIS (CRNP) is a healthcare provider. based in Lancaster, Pennsylvania. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. SP016270 (PA). The NPI Number for JESSICA JACQUELINE GILLIS (CRNP) is 1053760637

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA JACQUELINE GILLIS (CRNP)
NPI
1053760637
Phone
(717) 544-5681
Address
555 N DUKE ST
Enumeration Date
6 June 2016
Last Update Date
27 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7176262167
Graduation Year
2016 (10 years ago)
PAC ID
9032405170
Group Practice PAC ID
0941103683
Professional Enrollment ID
I20160915001794
Address ID
PA175431816LI562XXAVEX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness85
Years active:9State licenses:1Digital endpointsOther names

11,469 NURSE PRACTITIONER in PA

Provider Addresses for JESSICA JACQUELINE GILLIS (CRNP)

  • 555 N DUKE ST

    LANCASTER, PA 176022250

    Phone: (717) 544-5681

    Fax: (717) 544-4665

    Type: Location

  • 101 LARKSPUR LANE

    EPHRATA, PA 175228402

    Phone: (717) 738-0660

    Fax: (717) 738-0658

    Type: Mailing

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: 2016-09-15

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
I20160915001794INurse PractitionerPATBD

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 17602)

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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: 0941103683View full group profile
NameSpecialtyState
Family Practice, Addiction MedicinePA
N E U R O L O G YNY
Nurse PractitionerPA
H E M A T O L O G Y/ O N C O L O G YPA
Family PracticePA
-PA
Neurology, EpileptologistsPA
-PA
Family PracticePA
-PA

Reviews

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Frequently asked questions

Does JESSICA JACQUELINE GILLIS (CRNP) have a public NPI I can cite?
Public records show JESSICA JACQUELINE GILLIS (CRNP) under NPI 1053760637.
Should I treat JESSICA JACQUELINE GILLIS (CRNP) as an active provider?
Patients and plans typically see JESSICA JACQUELINE GILLIS (CRNP) as active in the national extract.
What does the directory say JESSICA JACQUELINE GILLIS (CRNP) does?
Insurance directories may phrase it differently, but here JESSICA JACQUELINE GILLIS (CRNP) maps to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is JESSICA JACQUELINE GILLIS (CRNP) tied to Lancaster, Pennsylvania?
If you are local to Lancaster, Pennsylvania, JESSICA JACQUELINE GILLIS (CRNP) may be relevant to your search.
Why is information missing for JESSICA JACQUELINE GILLIS (CRNP)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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