Jacqueline Clubine, CNM - Medicare Advanced Practice Midwife in Port Angeles, WA

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Jacqueline Clubine, CNM is a medicare enrolled "Advanced Practice Midwife" in Port Angeles, Washington. Her current practice location is 433 E 8th St, Port Angeles, Washington. You can reach out to her office (for appointments etc.) via phone at (360) 565-0999.

Jacqueline Clubine is licensed to practice in Washington (license number AP61546588) 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 1053812362.

Contact Information

Jacqueline Clubine, CNM
433 E 8th St,
Port Angeles, WA 98362-6219
(360) 565-0999
Not Available

Map and Direction




Provider's Profile

Full NameJacqueline Clubine
GenderFemale
SpecialityAdvanced Practice Midwife
Location433 E 8th St, Port Angeles, Washington
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1053812362
  • Provider Enumeration Date: 02/22/2018
  • Last Update Date: 06/05/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 1355697848
  • Enrollment ID: I20180713002259

Medical Identifiers

Medical identifiers for Jacqueline Clubine such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053812362NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367A00000XAdvanced Practice Midwife RN261851 (Georgia)Secondary
367A00000XAdvanced Practice Midwife AP61546588 (Washington)Primary
363LP0808XNurse Practitioner - Psychiatric/mental Health AP61546589 (Washington)Secondary

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. Jacqueline Clubine allows following entities to bill medicare on her behalf.
Entity NameWellstar Medical Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558664003
PECOS PAC ID: 6709065402
Enrollment ID: O20110127000374
Entity NameMedcura Health, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1417011487
PECOS PAC ID: 2961443643
Enrollment ID: O20120509000245

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. Jacqueline Clubine 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 AddressPractice Location Address
Jacqueline Clubine, CNM
Po Box 850,
Port Angeles, WA 98362-0146

Ph: (360) 565-0999		Jacqueline Clubine, CNM
433 E 8th St,
Port Angeles, WA 98362-6219

Ph: (360) 565-0999

Reviews and Comments


Advanced Practice Midwife Nurses in Port Angeles, WA

Mrs. Cheri Kate Shields, CNM
Advanced Practice Midwife
Medicare: Not Enrolled in Medicare
Practice Location: 907 Georgiana St, Port Angeles, WA 98362
Phone: 360-565-0999    Fax: 360-452-7303
Deborah Grace Bopp, ARNP
Advanced Practice Midwife
Medicare: Not Enrolled in Medicare
Practice Location: 939 Caroline St # 3e, Port Angeles, WA 98362
Phone: 360-565-0999    Fax: 360-452-7303
Brenda E Woods, CNM
Advanced Practice Midwife
Medicare: Medicare Enrolled
Practice Location: 433 E 8th St, Port Angeles, WA 98362
Phone: 360-565-0999    Fax: 360-452-7303
Cheri Van Hoover, CNM
Advanced Practice Midwife
Medicare: Not Enrolled in Medicare
Practice Location: 1106 E 1st St, Port Angeles, WA 98362
Phone: 360-452-2954    
Eleanor Margaret Gardner, CNM
Advanced Practice Midwife
Medicare: Medicare Enrolled
Practice Location: 433 E 8th St, Port Angeles, WA 98362
Phone: 360-565-0999    Fax: 360-452-7303
Laurie Lee Johnson Driese, CNM
Advanced Practice Midwife
Medicare: Medicare Enrolled
Practice Location: 939 Caroline St, Port Angeles, WA 98362
Phone: 360-565-0999    Fax: 360-452-7303

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.