Jacquelyn Stajcar

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A125696 Issued in IA

Practice address

19942 Saint Joseph Dr
Centerville, IA 52544-8849

Phone

(641) 856-8684

NPI assigned

Feb 17, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Medical Center-CentervilleGroup PAC ID 9739077652, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercyone Centerville Medical Center Hospital, Centerville, IA, CCN 161377

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jstajcar3958543@direct.trinity-health.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Medical Center-Centerville

  • Emergency Care Clinic/Center
  • Centerville, IA
  • NPI 1528018801
  Medicare reassignment Care Compare group NPD
• Mercy Medical Center-Centerville

  • Multi-Specialty Clinic/Center
  • Ottumwa, IA
  • NPI 1093360679
  NPD
• Mercy Medical Center-Centerville

  • Family Medicine Physician
  • Centerville, IA
  • NPI 1346290624
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Medical Center-Centerville

  • Critical Access Hospital
  • Centerville, IA
  • NPI 1356391635
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1114466513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 N 13TH ST",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525441737",
            "telephone_number": "641-895-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19942 SAINT JOSEPH DR",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525448849",
            "telephone_number": "641-856-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAJCAR",
        "first_name": "JACQUELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-17",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A125696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A125696",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jodi Smith, R.N.
• Neal R. Sokol, DO
• Southern Iowa Surgical Associates Inc
• Amy Spencer, PHARMD
• Julie A Spowart, RPH
• State University of Iowa
• Stater Dental
• Lauren Nicole Stayner
• Colleen Elizabeth Stephens, LISW BCO
• Cassidy Stewart

• Family Nurse Practitioner in Centerville, IA
• Providers in Centerville, IA by specialty
• Family Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.