NPIMap

Individual provider Active NPI

Jessica J Jachimiec, MD

  • Family Medicine Physician
  • Wasilla, AK
National Provider Identifier
1790964195
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
46079-20 Issued in WI
Practice address
3066 E Meridian Park Loop
Wasilla, AK 99654-7299
Phone
(907) 357-9590
NPI assigned
Nov 1, 2007
Last updated
Oct 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 46079-20 WI Primary

Addresses

Primary practice location

3066 E Meridian Park Loop
Wasilla, AK 99654-7299

Mailing address

3066 E Meridian Park Loop
Wasilla, AK 99654-7299
Phone (907) 357-9590

Other identifiers 1

IdentifierTypeStateIssuer
MD1390MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100312001042 AK Practitioner - Family Practice 8224163472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Network of Alaska LLCGroup PAC ID 3072618859, 70 clinicians

Practice addresses (Care Compare)

3122 E Meridian Park Loop
Wasilla, AK 99654-7255
Phone (907) 357-9590

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46079-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC CurrentSince Jun 1, 2019 Accepting new patients
Maple Springs of Palmer SNF Holdings, LLC PastSince Mar 1, 2025 Accepting new patients
Maple Springs of Wasilla SNF Holdings LLC Past Accepting new patients

Locations

3066 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

3122 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 864-4625

3190 E Meridian Park Loop
Ste 207
Wasilla, AK 99654
Phone (907) 357-7710

3331 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

Interoperability endpoints

  • Direct secure messaging: jessica.jachimiec.1@27294.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Maple Springs of WasillaWasilla, AK, CCN 025038 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Mar 1, 2025
Maple Springs of PalmerPalmer, AK, CCN 025039 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Mar 1, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1790964195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E MERIDIAN PARK LOOP",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547299",
            "telephone_number": "907-357-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 E MERIDIAN PARK LOOP",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547299",
            "telephone_number": "907-357-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACHIMIEC",
        "first_name": "JESSICA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "46079-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD1390",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.