Andrew Richard Jaconette, M.D.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

5328 Issued in AK

Practice address

851 E Westpoint Dr
Suite 203
Wasilla, AK 99654-7191

Phone

(907) 373-7934

Fax

(907) 677-6999

NPI assigned

Mar 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2025 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: arjaconette@direct.anthc.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.

• Alaska Native Tribal Health Consortium

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1437189339
  NPD
• Premier Medical Group, LLC

  • Physical Therapist
  • Anchorage, AK
  • NPI 1194849307

  Pain Medicine

  NPD (past)
• Anesthesiologist Associates PA

  • Anesthesiology Physician
  • Hudson, FL
  • NPI 1306889910
  NPD (past)
• Anesthesiology Associates of Tallahassee Inc

  • Anesthesiology Physician
  • Tallahassee, FL
  • NPI 1831171990
  NPD (past)
• Anesthesiology Associates of Tallahassee Inc

  • Anesthesiology Physician
  • Tallahassee, FL
  • NPI 1922772037
  NPD (past)

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

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1487778304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210850",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995210850",
            "telephone_number": "907-677-6900",
            "fax_number": "907-677-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 E WESTPOINT DR",
            "address_2": "SUITE 203",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547191",
            "telephone_number": "907-373-7934",
            "fax_number": "907-677-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACONETTE",
        "first_name": "ANDREW",
        "middle_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-17",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AK",
            "license": "5328",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AK",
            "license": "5328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016497",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Jackson
• Vicky Jackson
• Sarah E Jacobs, M.S. CCC-SLP
• Andrew Jacobsen, DPT
• Denali A Jacobsen
• Jaded Body Wellness & Spine Institute, LLC
• Hailey Blanchard Jamar, OTR/L
• Danielle Jarrett
• Jaybird Behavioral Health LLC
• Belisha Rochelle Jefferies

• Interventional Pain Medicine Physician in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Interventional Pain Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.