Jaclyn Anne Wagner, FNP in Gainesville, FL - Medicare Nurse Practitioner

Jaclyn Anne Wagner, FNP is a medicare enrolled "Nurse Practitioner" in Gainesville, Florida. She graduated from nursing school in 2010 and has 15 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Villages Regional Hospital Physician Services Llc, Flagler Professional Health Care Services Inc and her current practice location is 1600 Sw Archer Rd, Gainesville, Florida. You can reach out to her office (for appointments etc.) via phone at (352) 392-4541.

Jaclyn Anne Wagner is licensed to practice in Florida (license number APRN11020833) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1720372964.

Contact Information

	Jaclyn Anne Wagner, FNP
	1600 Sw Archer Rd, Gainesville, FL 32610-5776
	(352) 392-4541
	Not Available

Map and Direction

Provider's Profile

Full Name	Jaclyn Anne Wagner
Gender	Female
Speciality	Nurse Practitioner
Experience	15 Years
Location	1600 Sw Archer Rd, Gainesville, Florida
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Jaclyn Anne Wagner graduated from nursing school in 2010

NPI Data:

NPI Number: 1720372964
Provider Enumeration Date: 06/06/2011
Last Update Date: 09/03/2025

Medicare PECOS Information:

PECOS PAC ID: 4880862630
Enrollment ID: I20230918003983

Medical Identifiers

Medical identifiers for Jaclyn Anne Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720372964	NPI	-	NPPES
126442300	Medicaid	FL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	APRN11020833 (Florida)	Primary
363LF0000X	Nurse Practitioner - Family	APRN11020833 (Florida)	Secondary
207Q00000X	Family Medicine	APRN11020833 (Florida)	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Villages Regional Hospital Physician Services Llc	0244688893	170
Flagler Professional Health Care Services Inc	4082973953	40

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. Jaclyn Anne Wagner allows following entities to bill medicare on her behalf.

Entity Name	Florida Clinical Practice Association Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063463768 PECOS PAC ID: 0345146254 Enrollment ID: O20031211000099

Entity Name	Palm Harbor Family Practice And Walk-in Clinic, P.a
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1831311810 PECOS PAC ID: 9133108541 Enrollment ID: O20040719000940

Entity Name	Villages Regional Hospital Physician Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1700669926 PECOS PAC ID: 0244688893 Enrollment ID: O20231121001709

Entity Name	Flagler Professional Health Care Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811739873 PECOS PAC ID: 4082973953 Enrollment ID: O20241003000628

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. Jaclyn Anne Wagner 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
Jaclyn Anne Wagner, FNP Po Box 740861, Atlanta, GA 30374-0861 Ph: (904) 819-4539	Jaclyn Anne Wagner, FNP 1600 Sw Archer Rd, Gainesville, FL 32610-5776 Ph: (352) 392-4541

Reviews and Comments

Nurse Practitioner Nurses in Gainesville, FL

Susan Lynette Fort, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2528 Nw 32nd St, Gainesville, FL 32605 Phone: 352-224-8161 Fax: 321-320-8780
Xenia T Blount, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: Po Box 100224, Gainesville, FL 32610 Phone: 352-273-7832 Fax: 352-273-7849
Mrs. Brandace Michele Kenworthy, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1600 Sw Archer Rd, Gainesville, FL 32610 Phone: 352-265-0111
Miss Sadaf Nazar Malik, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1600 Sw Archer Rd, Gainesville, FL 32610 Phone: 904-265-0111
Mrs. Sara Renee West, FNP-C, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1600 Sw Archer Rd, Gainesville, FL 32610 Phone: 352-273-9000 Fax: 352-392-8413
Sandrie Rose Dieujuste, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1600 Sw Archer Rd, Gainesville, FL 32610 Phone: 352-265-0045
Holly Willis, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1601 Sw Archer Rd., Gainesville, FL 32608 Phone: 352-548-6000

Jaclyn Anne Wagner, FNP - Medicare Nurse Practitioner in Gainesville, FL