Jacquelyn Smith-douglas, FNP - Medicare Nurse Practitioner in Costa Mesa, CA

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Jacquelyn Smith-douglas, FNP is a medicare enrolled "Nurse Practitioner" in Costa Mesa, California. She graduated from nursing school in 2019 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Vital Medical Group Inc, Onyx Medical Group Inc and her current practice location is 150 Paularino Ave, Costa Mesa, California. You can reach out to her office (for appointments etc.) via phone at (949) 556-3433.

Jacquelyn Smith-douglas is licensed to practice in California (license number F07210327) 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 1598336828.

Contact Information

Jacquelyn Smith-douglas, FNP
150 Paularino Ave,
Costa Mesa, CA 92626-3301
(949) 556-3433
Not Available

Map and Direction




Provider's Profile

Full NameJacquelyn Smith-douglas
GenderFemale
SpecialityNurse Practitioner
Experience7 Years
Location150 Paularino Ave, Costa Mesa, California
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jacquelyn Smith-douglas graduated from nursing school in 2019
  NPI Data:
  • NPI Number: 1598336828
  • Provider Enumeration Date: 07/07/2021
  • Last Update Date: 12/29/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 2466846811
  • Enrollment ID: I20220228002673

Medical Identifiers

Medical identifiers for Jacquelyn Smith-douglas such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1598336828NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner F07210327 (California)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Vital Medical Group Inc55971069306
Onyx Medical Group Inc38700165798

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. Jacquelyn Smith-douglas allows following entities to bill medicare on her behalf.
Entity NameMinuteclinic Diagnostic Medical Group Of California Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033309372
PECOS PAC ID: 8224191374
Enrollment ID: O20090115000289
Entity NameMinuteclinic Diagnostic Medical Group Of Orange County Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104013879
PECOS PAC ID: 5991868929
Enrollment ID: O20090116000214
Entity NameMinuteclinic Diagnostic Medical Group Of San Diego Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1568659233
PECOS PAC ID: 2567520414
Enrollment ID: O20090127000249
Entity NameRemedial Medical Services Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083216998
PECOS PAC ID: 3678986890
Enrollment ID: O20210107002339
Entity NameRemedial Patients Care Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1508507229
PECOS PAC ID: 1254719909
Enrollment ID: O20220608001354
Entity NameVital Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124886437
PECOS PAC ID: 5597106930
Enrollment ID: O20240515004361
Entity NameOnyx Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1851191019
PECOS PAC ID: 3870016579
Enrollment ID: O20250402002525

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. Jacquelyn Smith-douglas 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
Jacquelyn Smith-douglas, FNP
8441 Renwick Dr,
Corona, CA 92883-5931

Ph: (323) 251-0477		Jacquelyn Smith-douglas, FNP
150 Paularino Ave,
Costa Mesa, CA 92626-3301

Ph: (949) 556-3433

Reviews and Comments


Nurse Practitioner Nurses in Costa Mesa, CA

Alexandra Hutchison, FNP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 1530 Baker St Ste A, Costa Mesa, CA 92626
Phone: 714-559-5436    
Lea D Wood, AGNP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 711 W 17th St, Costa Mesa, CA 92627
Phone: 949-209-8953    
Judith Rivera, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 600 Anton Blvd Fl 11, Costa Mesa, CA 92626
Phone: 623-374-7774    Fax: 855-420-6361
Madison Lucas,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 150 Paularino Ave Ste D182, Costa Mesa, CA 92626
Phone: 866-300-7227    
Summer Marie Del Real, PMHNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 301 Victoria St, Costa Mesa, CA 92627
Phone: 949-642-2734    
Mrs. Suzanne Clara Larkin, FNP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 1665 Scenic Ave, Costa Mesa, CA 92626
Phone: 714-436-4444    
Rachel Renee Cliser, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 188 E 17th St Ste 101, Costa Mesa, CA 92627
Phone: 949-515-4548    

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.