JACQUELINE C. FIELDS M.D.
NPI 1043202385
Specialist in Fort Collins, CO

NPI Status: Active since August 22, 2005

Contact Information

315 CANYON AVE
SUITE 1
FORT COLLINS, CO
ZIP 80521
Phone: (970) 472-6789
Fax: (970) 472-6799

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  • Individual
  • Female
  • Specialist
  • PECOS Enrolled
  • Opted-Out Medicare

About JACQUELINE FIELDS

This page provides the complete NPI Profile along with additional information for Jacqueline Fields, a provider established in Fort Collins, Colorado with a medical specialization in Specialist. The healthcare provider is registered in the NPI registry with number 1043202385 assigned on August 2005. The practitioner's primary taxonomy code is 174400000X with license number 33698 (CO). The provider is registered as an individual and her NPI record was last updated 13 years ago.

NPI
1043202385
Provider Name
JACQUELINE C. FIELDS M.D.
Gender
Female
Entity Type
Individual
Location Address
315 CANYON AVE SUITE 1 FORT COLLINS, CO 80521
Location Phone
(970) 472-6789
Location Fax
(970) 472-6799
Mailing Address
315 CANYON AVE SUITE 1 FORT COLLINS, CO 80521
Mailing Phone
(970) 472-6789
Mailing Fax
(970) 472-6799
Is Sole Proprietor?
Yes
Enumeration Date
08-22-2005
Last Update Date
10-02-2013
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The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Jacqueline Fields opted out of Medicare effective on 12-13-2017 until 12-13-2025. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
33698
License State
CO
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
F86554MEDICARE UPIN (02)CO 
522628MEDICARE ID-TYPE UNSPECIFIED (04)CO 
01336981MEDICAID (05)CO 

Medicare Participation & PECOS Enrollment Status

Jacqueline Fields is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Opted-Out of Medicare? Yes

  • Opt-Out Effective Date: 12-13-2017

  • Opt-Out End Date: 12-13-2025

  • Eligible to Order and Refer? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1043202385, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
4
Doubled → 8
Pos 4
3
Unchanged
Pos 5
2
Doubled → 4
Pos 6
0
Unchanged
Pos 7
2
Doubled → 4
Pos 8
3
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 2 → 4 2 → 4 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 8 + 3 + 4 + 0 + 4 + 3 + 1 + 6 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1043202385.

Other Providers at the Same Location


The following 10 providers are registered at the same or a nearby location.

Nurse Practitioner (Pediatrics)
315 CANYON AVE, SUITE A
FORT COLLINS, CO 80521
Family Medicine
315 CANYON AVE, SUITE1
FORT COLLINS, CO 80521
Psychologist (Clinical)
315 CANYON AVE, SUITE A
FORT COLLINS, CO 80521
Family Medicine
315 CANYON AVE, SUITE 1
FORT COLLINS, CO 80521
Specialist
315 CANYON AVE
FORT COLLINS, CO 80521
Massage Therapist
315 CANYON AVE, SUITE A
FORT COLLINS, CO 80521
Psychologist (Clinical)
315 CANYON AVE, SUITE A
FORT COLLINS, CO 80521
Community/Behavioral Health
315 CANYON AVE, SUITE B.
FORT COLLINS, CO 80521
Family Medicine
315 CANYON AVE, SUITE 3
FORT COLLINS, CO 80521
Counselor (Mental Health)
315 CANYON AVE
FORT COLLINS, CO 80521

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043202385, enumerated as an "individual" on August 22, 2005.

The provider is located at 315 CANYON AVE SUITE 1 FORT COLLINS, CO 80521 and the phone number is (970) 472-6789.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.