Frederick John Jaecklein, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

63733 Issued in TN

Practice address

1211 Union Ave Ste 300
Memphis, TN 38104-6655

Phone

(901) 272-6018

Fax

(901) 201-4203

NPI assigned

Jul 8, 2014

Last updated

Jun 6, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Vascular Surgery

Education

Jefferson Medical College of Thomas Jefferson University, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ut Methodist Physicians LLCGroup PAC ID 2769623669, 123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
• Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167
• Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fjaecklein26157@mlh.direct-ci.com

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

• Ut Methodist Physicians LLC

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1427317908

  Vascular Surgery

  Medicare reassignment Care Compare group NPD
• Premier Vascular Associates, PLLC

  • Vascular Surgery Physician
  • Saint Clair Shores, MI
  • NPI 1972904951
  NPD

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

• Methodist Healthcare - Memphis Hospitals

  dba Le Bonheur Children's Hospital

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  dba Le Bonheur Children's Hospital - Germantown

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450
  Care Compare affiliation
• Grand Strand Regional Medical Center LLC

  dba Grand Strand Medical Center

  • General Acute Care Hospital
  • Myrlte Beach, SC
  • NPI 1083668669
  Care Compare affiliation
• Methodist Healthcare - Olive Branch Hospital

  • General Acute Care Hospital
  • Olive Branch, MS
  • NPI 1912341439
  Care Compare affiliation

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1215343553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655",
            "telephone_number": "901-272-6018",
            "fax_number": "901-201-4203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6401 Poplar Ave Ste 540",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381194823",
            "country_code": "US",
            "telephone_number": "901-478-0900",
            "fax_number": "901-201-4203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAECKLEIN",
        "first_name": "FREDERICK",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-08",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "63733",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301095037",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Jacoby, M.A. SLPE
• Lisa M Jacola, PH.D.
• Jacqueline London (5 Star Transit)
• Jaded Lotus ABA LLC
• Jaded Lotus Academy
• Jaeco Staffing (Jaeco Homehealth)
• Robin Jaffe, LADAC
• Bhuvaneshwari Jagadesan, M.D.
• Aakriti Jain
• Manoj K Jain, MD, MPH

• Vascular Surgery Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Vascular Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; 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.