Miss Jaclynn Pauline Back, APRN in Newark, OH

Miss Jaclynn Pauline Back, APRN is a medicare enrolled "Nurse Practitioner - Family" in Newark, Ohio. She graduated from nursing school in 2012 and has 13 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Boulder Care Provider Group Pa, Boulder Care Provider Group Pa, Boulder Care Provider Group Pa and her current practice location is 1445 W Main St, Newark, Ohio. You can reach out to her office (for appointments etc.) via phone at (513) 834-7063.

Miss Jaclynn Pauline Back is licensed to practice in Ohio (license number APRN.CNP.13665) 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 1770835506.

Contact Information

	Miss Jaclynn Pauline Back, APRN
	1445 W Main St, Newark, OH 43055-1989
	(513) 834-7063
	(513) 873-1567

Map and Direction

Provider's Profile

Full Name	Miss Jaclynn Pauline Back
Gender	Female
Speciality	Nurse Practitioner
Experience	13 Years
Location	1445 W Main St, Newark, Ohio
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:

Miss Jaclynn Pauline Back graduated from nursing school in 2012

NPI Data:

NPI Number: 1770835506
Provider Enumeration Date: 10/03/2012
Last Update Date: 10/03/2024

Medicare PECOS Information:

PECOS PAC ID: 6103076500
Enrollment ID: I20121019000584

Medical Identifiers

Medical identifiers for Miss Jaclynn Pauline Back such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1770835506	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	RN.313249 (Ohio)	Secondary
363LF0000X	Nurse Practitioner - Family	APRN.CNP.13665 (Ohio)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Boulder Care Provider Group Pa	6901217447	59
Boulder Care Provider Group Pa	6901217447	59
Boulder Care Provider Group Pa	6901217447	59

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. Miss Jaclynn Pauline Back allows following entities to bill medicare on her behalf.

Entity Name	Brightview Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1659769446 PECOS PAC ID: 9032426044 Enrollment ID: O20150923000820

Entity Name	Boulder Care Provider Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1649838590 PECOS PAC ID: 6901217447 Enrollment ID: O20220201002891

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. Miss Jaclynn Pauline Back 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
Miss Jaclynn Pauline Back, APRN 4600 Montgomery Rd Ste 400, Cincinnati, OH 45212-2600 Ph: () -	Miss Jaclynn Pauline Back, APRN 1445 W Main St, Newark, OH 43055-1989 Ph: (513) 834-7063

Reviews and Comments

Nurse Practitioner Nurses in Newark, OH

Joan Crumrine, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Licking Memorial Family Practice East, 399 E. Main St, Newark, OH 43055 Phone: 220-564-1846 Fax: 220-564-1847
Anna Ruhl, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1320 W Main St, Newark, OH 43055 Phone: 220-564-4151 Fax: 220-564-7153
Mrs. Sarah Elizabeth Karling, APRN, WHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15 Messimer Dr, Newark, OH 43055 Phone: 220-564-4677
Andrea Sims, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1320 W Main St, Newark, OH 43055 Phone: 220-564-4000
Ms. Amanda K Miller, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 68 W Church St Ste 203, Newark, OH 43055 Phone: 740-934-6474 Fax: 740-934-6473
Catherine R Wohlford, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 399 E Main St, Newark, OH 43055 Phone: 220-564-1840 Fax: 220-564-1841
Robert Storm Speelman, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1320 W Main St, Newark, OH 43055 Phone: 220-564-4144 Fax: 220-564-7153

Miss Jaclynn Pauline Back, APRN - Medicare Nurse Practitioner in Newark, OH