Individual provider Active NPI

Jacquelyn Schnackel Porzucek, APRN-CNP

  • Neonatal Nurse Practitioner
  • Burlington, VT
National Provider Identifier
1972120129
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
101.0136923 Issued in VT
Practice address
111 Colchester Ave
Burlington, VT 05401-1473
Phone
(802) 847-2370
Fax
(802) 847-8590
NPI assigned
Jul 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 026.0152967 VT
Neonatal Nurse Practitioner 363LN0000X 101.0136923 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Burlington, VT 05401-1473

Mailing address

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-2370

Other names 1

  • Jacquelyn Fain Schnackel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, VT2 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

Enrollment IDStateProvider typePAC IDDetails
I20210304001819 OH Practitioner - Nurse Practitioner 6709292469 Reassigns benefits to 1 organization
I20250303000223 VT Practitioner - Nurse Practitioner 6709292469 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026.0152967VTMDNeonatal Intensive Care Registered Nurse
101.0136923VTMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc CurrentSince Jan 26, 2025 Accepting new patients

Locations

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

Interoperability endpoints

  • Direct secure messaging: jschnackel588251@direct.uvmhealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1972120129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-2370",
            "fax_number": "802-847-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORZUCEK",
        "first_name": "JACQUELYN",
        "middle_name": "SCHNACKEL",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "VT",
            "license": "026.0152967",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "VT",
            "license": "101.0136923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "SCHNACKEL",
            "middle_name": "FAIN",
            "credential": "APRN-CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.