HAEJIN JACK APRN-CNP
NPI 1033949508
Nurse Practitioner - Acute Care in Columbus, OH

Q: What is Haejin Jack's NPI number?

The NPI number for Haejin Jack is 1033949508. It was assigned to this individual provider in the NPPES registry on August 7, 2024.

Q: What is Haejin Jack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Haejin Jack was last updated on July 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 07, 2024PECOS EnrolledAccepts Medicare Assignment

460 W 10TH AVE, COLUMBUS, OH 43210(614) 293-7499(614) 366-2360 Get Directions Write a Review

NPPES record last updated: July 21, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 26, 2024, Aug 7, 2024 (2 updates tracked since 2024).

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About Haejin Jack Aprn-cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HAEJIN JACK APRN-CNP (NPI 1033949508) is an individual acute care provider in Columbus, Ohio, licensed in Ohio (APRN.CNP.0037626) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS, is affiliated with Ohio State University State Health System, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1033949508

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameHAEJIN JACKCredential: APRN-CNP

Location Address460 W 10TH AVEColumbus, OH 43210-1240

Mailing Address700 Ackerman Rd Ste 2120Columbus, OH 43202-1559 · (614) 293-7499 · Fax (614) 366-2360

Phone(614) 293-7499

Fax(614) 366-2360

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateAugust 7, 2024

Last NPPES UpdateJuly 21, 20252 updates tracked since enumeration

NPPES CertifiedJuly 21, 2025

✔ NPI 1033949508 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in OH · APRN.CNP.0037626

460 W 10TH AVE, Columbus, OH 43210

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Ohio, Inc., CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Haejin Jack Aprn-cnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4183157811

PECOS Enrollment IDI20241101001502

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ohio State University State Health System

Acute Care Hospitals · Columbus, OH

4/5 CMS rating

OwnershipGovernment - State

CMS Certification Number360085

Location410 West 10th AvenueColumbus, OH 43210 · Franklin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43210 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHIEMEZIE CHIANOTU AMADI MD

Radiology (Diagnostic Radiology)