Jaclyn Mae Freese, PA-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

001484 Issued in IA

Practice address

800 Oak St
Sheldon, IA 51201-1242

Phone

(712) 324-5356

Fax

(712) 324-6515

NPI assigned

Apr 11, 2006

Last updated

Apr 18, 2022By 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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA, MN2 enrollments

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 2

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Health NetworkGroup PAC ID 6800707100, 357 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Worthington Medical Center Hospital, Worthington, MN, CCN 240022

Merit-based Incentive Payment System (MIPS)

Final score

85.53 of 100Reported as group

Quality

80.98

Promoting interoperability

100

Improvement activities

40

Cost

70.78

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jfreese4576@direct.sanfordhealth.org

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.

• Sanford Health Network

  dba Sanford Clinic Tracy

  • Family Medicine Physician
  • Tracy, MN
  • NPI 1699869875
  Medicare reassignment Care Compare group
• Sanford Health Network

  dba Sanford Health Lake Park Clinic

  • Multi-Specialty Clinic/Center
  • Lake Park, IA
  • NPI 1134787930
  Medicare reassignment
• Sanford Health Network

  dba Sanford Clinic Sanborn

  • Family Medicine Physician
  • Sanborn, IA
  • NPI 1831372077
  NPD
• Sanford Health Network

  dba Sanford Clinic Mountain Lake

  • Rural Health Clinic/Center
  • Mountain Lake, MN
  • NPI 1568469039
  NPD
• Sanford Health Network

  dba Sanford Health Adrian Clinic

  • Rural Acute Care Hospital
  • Worthington, MN
  • NPI 1679859912

  Nurse Practitioner

  NPD
• Sanford Clinic

  dba Sanford Health Adrian Clinic

  • Family Medicine Physician
  • Adrian, MN
  • NPI 1831178052
  NPD (past)

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

• Sanford Health Network

  dba Sanford Worthington Medical Center

  • Rural Acute Care Hospital
  • Worthington, MN
  • NPI 1396712618
  Care Compare affiliation
• Sanford Health Network

  dba Sanford Health Adrian Clinic

  • Rural Acute Care Hospital
  • Worthington, MN
  • NPI 1679859912
  Care Compare affiliation

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1871556787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 OAK ST",
            "address_2": "P.O. BOX 10",
            "city": "SHELDON",
            "state": "IA",
            "postal_code": "512011242",
            "telephone_number": "712-324-5356",
            "fax_number": "712-324-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 OAK ST",
            "city": "SHELDON",
            "state": "IA",
            "postal_code": "512011242",
            "telephone_number": "712-324-5356",
            "fax_number": "712-324-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREESE",
        "first_name": "JACLYN",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "001484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0254656",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0638593",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfreese4576@direct.sanfordhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "800 Oak St",
            "city": "Sheldon",
            "state": "IA",
            "country_code": "US",
            "postal_code": "512011242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nurse Practitioner in Sheldon, IA
• Providers in Sheldon, IA by specialty
• Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.