DENISE JACKS (ARNP) – Adult Health Nurse Practitioner, NPI 1104136738
Adult Health Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DENISE JACKS (ARNP)
1301 2ND AVE SW
LARGO, FL 337703120
Phone: (727) 581-8767
Fax: (727) 581-3727
Type: Mailing
6101 BLUE LAGOON DR STE 200
MIAMI, FL 331263168
Phone: (305) 500-2000
Type: Mailing
3691 CLYDE MORRIS BLVD
PORT ORANGE, FL 321292317
Phone: (386) 675-4411
Fax: (866) 542-5859
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 20 Open Payments records for all available years, with a total value of $1,773.
Total Amount is formed as General ($1,773) + Research ($0) + Ownership ($0) = $1,773.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Abbott Laboratories ($362).
Total Amount
$1,773
General + Research + Ownership
Payments
20
Total payment records
General Amount
$1,773
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $362 |
| AstraZeneca Pharmaceuticals LP | $220 |
| Actelion Pharmaceuticals US, Inc. | $124 |
| Boston Scientific Corporation | $123 |
| Axonics, Inc. | $118 |
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: 2024-07-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20110421000484 | I | Nurse Practitioner | FL | TBD |
| I20240717003438 | I | Nurse Practitioner | TX | 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 33770)
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