Jennifer Ellen Jacky, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP30007362 Issued in WA

Practice address

825 Eastlake Ave E
Seattle, WA 98109

Phone

(206) 606-6692

Fax

(206) 606-1435

NPI assigned

Nov 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fred Hutchinson Cancer Center Hospital, Seattle, WA, CCN 500138
• University of Washington Medical Ctr Hospital, Seattle, WA, CCN 500008

Merit-based Incentive Payment System (MIPS)

Final score

93.85 of 100Reported as apm

Quality

74.6

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjacky112592@direct.ehre.uwmedicine.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.

• The Association of University Physicians

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1023041159
  Medicare reassignment Care Compare group NPD
• Pain Consultants of Washington, PLLC

  • Interventional Pain Medicine Physician
  • Kirkland, WA
  • NPI 1437189818
  NPD (past)

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

• Fred Hutchinson Cancer Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1164493847
  Care Compare affiliation
• Fred Hutchinson Cancer Center

  • Community/Retail Pharmacy
  • Seattle, WA
  • NPI 1356415699

  Hospital

  Care Compare affiliation
• University of Washington

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1326002049
  Care Compare affiliation

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1275606774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 EASTLAKE AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98109",
            "telephone_number": "206-606-6692",
            "fax_number": "206-606-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKY",
        "first_name": "JENNIFER",
        "middle_name": "ELLEN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30007362",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30007362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275606774",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0274647",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne E Jackson, AU.D.
• Tamara E Jackson, P.A.
• Tyler Jackson
• Zultsetseg Wagner Jackson, PA-C
• Hannah Jacky, LSWAIC
• Jennifer Mara Jacob, MD
• Mini Elizabeth Jacob, MD, PHD
• Shevin T Jacob, MD, MPH
• Jessica Maria Jacobo, PHARMD
• Andrew D Jacobs, MD

• Family Nurse Practitioner in Seattle, WA
• Providers in Seattle, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.