JACQUELINE VAN GHEEM (MD) – Orthopaedic Surgery Physician, NPI 1699399352

JACQUELINE VAN GHEEM (MD) is a healthcare provider. based in Lubbock, Texas. specializing in ORTHOPEDIC SURGERY. They hold the professional credentials MD. They hold a License No. 85550-20 (WI). The NPI Number for JACQUELINE VAN GHEEM (MD) is 1699399352

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
JACQUELINE VAN GHEEM (MD)
NPI
1699399352
Phone
(806) 743-2465
Address
3601 4TH ST # MS 9436
Enumeration Date
28 May 2020
Last Update Date
24 July 2025

Doctor Profile

Medical School Name
LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Secondary Phone
7153692300
Graduation Year
2020 (6 years ago)
PAC ID
8224452065
Group Practice PAC ID
1052223625
Professional Enrollment ID
I20250912003264
Address ID
WI545012852RH444XXDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness85
Years active:6State licenses:1Digital endpointsOther names

2,189 ORTHOPEDIC SURGERY in TX

Provider Addresses for JACQUELINE VAN GHEEM (MD)

  • 3601 4TH ST # MS 9436

    LUBBOCK, TX 794300002

    Phone: (806) 743-2465

    Type: Location

  • 3601 4th St # MS 9436

    Lubbock, TX 794300002

    Phone: (806) 743-2465

    Type: Location

  • 2251 N SHORE DR

    RHINELANDER, WI 545016713

    Phone: (715) 361-2000

    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: 2025-09-12

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
I20250912003264IOrthopedic SurgeryWITBD

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 79430)

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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: 1052223625View full group profile
NameSpecialtyState
Nurse PractitionerWI
O B S T E T R I C S/ G Y N E C O L O G YWI
Nurse PractitionerIL
Nurse PractitionerWI
-NC
-WI
N E U R O L O G YIL
-PA
-WI
-WI

Reviews

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Frequently asked questions

Is there an official ID for JACQUELINE VAN GHEEM (MD) in U.S. healthcare records?
The official identifier for JACQUELINE VAN GHEEM (MD) is NPI 1699399352.
Is there an active status for JACQUELINE VAN GHEEM (MD)?
For scheduling context, JACQUELINE VAN GHEEM (MD) is shown as active in the registry.
What area of care is associated with JACQUELINE VAN GHEEM (MD)?
JACQUELINE VAN GHEEM (MD)'s record emphasizes Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
Where in Texas is JACQUELINE VAN GHEEM (MD) registered?
Use Lubbock, Texas as the headline location for JACQUELINE VAN GHEEM (MD) here.
When was this NPI issued?
Enumeration for JACQUELINE VAN GHEEM (MD) is noted as May 28, 2020 where the registry provides it.

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