Individual provider Active NPI

Robert L. Jacques, ARNP

  • Family Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1922094259
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP917588 Issued in FL
Practice address
130 Pablo St
Lakeland, FL 33803-3818
Phone
(863) 687-1259
Fax
(863) 284-1786
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP917588 FL Primary

Addresses

Primary practice location

130 Pablo St
Lakeland, FL 33803-3818

Mailing address

1324 Lakeland Hills Blvd
Attn: Managed Care Dept
Lakeland, FL 33805-4543
Phone (863) 687-1100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rjacques17774@LRHS.direct-ci.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040707000746 FL Practitioner - Nurse Practitioner 0547247595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

130 Pablo St
Lakeland, FL 33803-3818
Phone (863) 284-5941

Hospital & facility affiliations

  • Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157

Merit-based Incentive Payment System (MIPS)

Final score
86.12 of 100Reported as group
Quality
64.08
Promoting interoperability
98
Improvement activities
40
Cost
76.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP917588FLMDFamily Nurse Practitioner

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Lakeland Regional Health Systems, Inc. CurrentSince Apr 1, 2008 Accepting new patients
Lakeland Regional Medical Center, Inc. Past Accepting new patients

Locations

1324 Lakeland Hills Blvd
Ofc
Lakeland, FL 33805
Phone (863) 687-1177

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

130 Pablo St
Lakeland, FL 33803
Phone (863) 284-5064

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rjacques17774@lrhs.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1922094259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "address_2": "ATTN: MANAGED CARE DEPT",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543",
            "telephone_number": "863-687-1100",
            "fax_number": "863-630-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PABLO ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033818",
            "telephone_number": "863-687-1259",
            "fax_number": "863-284-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "ROBERT",
        "middle_name": "L.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP917588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rjacques17774@LRHS.direct-ci.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "130 Pablo St",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338033818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.