ILIANA JACKSON (FNP) – Family Nurse Practitioner, NPI 1275366031

ILIANA JACKSON (FNP) is a healthcare provider. based in Boerne, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 1173678 (TX). The NPI Number for ILIANA JACKSON (FNP) is 1275366031

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
ILIANA JACKSON (FNP)
NPI
1275366031
Phone
(830) 816-5007
Address
112 HERFF RD STE 250
Enumeration Date
26 August 2024
Last Update Date
17 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8302570375
Graduation Year
2024 (2 years ago)
PAC ID
2668903584
Group Practice PAC ID
7315125960
Professional Enrollment ID
I20241002004196
Address ID
TX780285200KE420XXSTXX304
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

22,209 NURSE PRACTITIONER in TX

Provider Addresses for ILIANA JACKSON (FNP)

  • 112 HERFF RD STE 250

    BOERNE, TX 780062751

    Phone: (830) 816-5007

    Fax: (830) 257-0049

    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 14 Open Payments records for all available years, with a total value of $344.

Total Amount is formed as General ($344) + Research ($0) + Ownership ($0) = $344.

Last reported payment date: 2024-12-16 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($111).

Total Amount

$344

General + Research + Ownership

Payments

14

Total payment records

General Amount

$344

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-16

Latest reported date

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: 2024-10-02

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
I20241002004196INurse PractitionerTXTBD

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 78006)

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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: 7315125960View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerTX
Gastroenterology, Internal MedicineTX

Reviews

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Frequently asked questions

Is ILIANA JACKSON (FNP) listed with a National Provider Identifier?
Yes — ILIANA JACKSON (FNP) has NPI 1275366031 on file in the registry.
Would ILIANA JACKSON (FNP) appear as active to a payer?
You can treat ILIANA JACKSON (FNP) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is ILIANA JACKSON (FNP)?
ILIANA JACKSON (FNP) is associated with Family Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Where in Texas is ILIANA JACKSON (FNP) registered?
Use Boerne, Texas as the headline location for ILIANA JACKSON (FNP) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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