Amanda Jacques, in Portsmouth, NH - Medicare Nurse Practitioner

Amanda Jacques, is a medicare enrolled "Nurse Practitioner - Family" in Portsmouth, New Hampshire. Her current practice location is 330 Borthwick Ave Ste 101, Portsmouth, New Hampshire. You can reach out to her office (for appointments etc.) via phone at (603) 436-7171.

Amanda Jacques is licensed to practice in New Hampshire (license number 082661-21) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1417772369.

Contact Information

	Amanda Jacques,
	330 Borthwick Ave Ste 101, Portsmouth, NH 03801-4102
	(603) 436-7171
	(603) 433-5931

Map and Direction

Provider's Profile

Full Name	Amanda Jacques
Gender	Female
Speciality	Nurse Practitioner - Family
Location	330 Borthwick Ave Ste 101, Portsmouth, New Hampshire
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417772369
Provider Enumeration Date: 11/16/2024
Last Update Date: 07/17/2025

Medicare PECOS Information:

PECOS PAC ID: 1557890001
Enrollment ID: I20250128004090

Medical Identifiers

Medical identifiers for Amanda Jacques such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417772369	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	082661-21 (New Hampshire)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amanda Jacques allows following entities to bill medicare on her behalf.

Entity Name	Pmc Medical Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396121240 PECOS PAC ID: 0345545737 Enrollment ID: O20160223001322

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Jacques is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Amanda Jacques, 330 Borthwick Ave Ste 101, Portsmouth, NH 03801-4102 Ph: (603) 436-7171	Amanda Jacques, 330 Borthwick Ave Ste 101, Portsmouth, NH 03801-4102 Ph: (603) 436-7171

Reviews and Comments

Nurse Practitioner Nurses in Portsmouth, NH

Jill Capobianco, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 Campus Dr, Suite 12, Portsmouth, NH 03801 Phone: 603-422-8208 Fax: 603-422-8219
Ms. Anne Mcgann, A.R.N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 330 Borthwick Ave, Suite 202, Portsmouth, NH 03801 Phone: 603-436-7171
Krystle Lee Disorbo, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3201 Lafayette Rd, Portsmouth, NH 03801 Phone: 603-380-9159
Vanessa R Amatucci, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 67 Corporate Dr, Portsmouth, NH 03801 Phone: 603-610-8051
Heidi J Tzizik, APRN, FNP-C Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 599 Lafayette Rd, Portsmouth, NH 03801 Phone: 603-942-7900 Fax: 603-630-1009
Sarah Elizabeth Boyatsis, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 200 Griffin Rd Ste 15, Portsmouth, NH 03801 Phone: 603-373-0096
Kaitlin Elizabeth Stolberg Cohen, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 188 Jones Ave, Portsmouth, NH 03801 Phone: 603-431-2530

Amanda Jacques, - Medicare Nurse Practitioner in Portsmouth, NH