Jacqueline Suzanne Sebastian, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5002018 Issued in NC

Practice address

790 SE Cary Pkwy Ste 101
Cary, NC 27511-5678

Phone

(919) 231-3966

Fax

(919) 231-3912

NPI assigned

Aug 29, 2006

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 names 1

• Miss Jacqueline Suzanne Charles Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Carolina Nephrology PAGroup PAC ID 0244511483, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rex Hospital Hospital, Raleigh, NC, CCN 340114
• Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsebastian24291@direct.acumenmd.com

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.

• North Carolina Nephrology PA

  • Nephrology Physician
  • Raleigh, NC
  • NPI 1750835336
  Medicare reassignment Care Compare group NPD
• North Carolina Nephrology PA

  • Nephrology Physician
  • Dunn, NC
  • NPI 1053815993
  NPD
• North Carolina Nephrology PA

  • Nephrology Physician
  • Cary, NC
  • NPI 1811492663
  NPD

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

• Rex Hospital Inc.

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1497797088
  Care Compare affiliation
• Wakemed

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302
  Care Compare affiliation
• Wakemed

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1972579837
  Care Compare affiliation

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1386752228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 BARRETT DR STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097213",
            "telephone_number": "919-231-3966",
            "fax_number": "919-231-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 SE CARY PKWY STE 101",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275115678",
            "telephone_number": "919-231-3966",
            "fax_number": "919-231-3912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 Barrett Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276097213",
            "country_code": "US",
            "telephone_number": "919-231-3966",
            "fax_number": "919-231-3912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEBASTIAN",
        "first_name": "JACQUELINE",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5002018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ncnephrologyassociates@directaddress.net",
            "affiliation": "N",
            "address_1": "3700 Barrett Dr Ste 200",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276097213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "CHARLES",
            "middle_name": "SUZANNE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Demetrice J Scurlock
• Seabrook Wellness Collective
• Mary Candace Seagle, PA-C
• Carolyn Annette Fonville Seale, DPT
• Patricia Anne Sease
• Robert Seckler
• Annemarie Therese Seeley, BT
• Logan Seelman
• Sefried & Sefried LLC
• David Franklin Sefried, D.C.

• Nurse Practitioner in Cary, NC
• Providers in Cary, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.