Jessica Nicole Chacko, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME150652 Issued in FL

Practice address

12649 Horseshoe Bend Dr
Lithia, FL 33547-3311

Phone

(775) 233-7196

NPI assigned

Apr 24, 2018

Last updated

Aug 21, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: drjessicachacko@org223.direct.charmhealth.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.

• Nadal Pediatrics, LLC

  • Pediatrics Physician
  • Brandon, FL
  • NPI 1013988146
  NPD

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1790273852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12649 HORSESHOE BEND DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335473311",
            "telephone_number": "775-233-7196",
            "fax_number": "813-576-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12649 HORSESHOE BEND DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335473311",
            "telephone_number": "775-233-7196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "970 Cypress Village Blvd",
            "address_purpose": "LOCATION",
            "city": "Sun City Center",
            "state": "FL",
            "postal_code": "335736830",
            "country_code": "US",
            "telephone_number": "813-359-1561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME150652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cara Vaca de la Cruz (My Doctor On Call)
• Maria Fernanda Carpio
• Lonnie Carr, RPH
• Natasha Paola Carrero Mercado, DO
• Valerie Castro, DMD
• Colin R Chambers, PHYSICIAN ASSISTANT
• Cassandra Lauren Chavers
• Frank Alexander Chavez
• Asia M Childs
• Cassandra Treann Cintron-Rivera

• Pediatrics Physician in Lithia, FL
• Providers in Lithia, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.