MRS. JACLYN KIMBERLY FORAKER FNP-C
NPI 1073139465
Nurse Practitioner - Family in Bangor, ME

Active since June 22, 2020PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
360 BROADWAY, BANGOR, ME 04401(207) 907-1155(207) 907-1888 Get Directions Write a Review

NPPES record last updated: February 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 21, 2022, Jun 22, 2020 (2 updates tracked since 2020).

About Mrs. Jaclyn Kimberly Foraker Fnp-c NPPES

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

MRS. JACLYN KIMBERLY FORAKER FNP-C (NPI 1073139465) is an individual family provider in Bangor, Maine, licensed in Maine (CNP201144) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS, is affiliated with St Joseph Hospital, and maintains 7 additional practice locations.

NPPES Registry Identity

NPI1073139465
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. JACLYN KIMBERLY FORAKERCredential: FNP-C
Location Address360 BROADWAYBangor, ME 04401-3979
Mailing AddressC/o St Marys Health System - Provider Enrollment, Po Box 7291Lewiston, ME 04243-7291 · (207) 777-8941 · Fax (207) 777-8800
Fax(207) 907-1888
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJune 22, 2020
Last NPPES UpdateFebruary 21, 20222 updates tracked since enumeration
NPPES CertifiedOctober 4, 2021
NPI 1073139465 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in ME · CNP201144
Also ListedNurse Practitioner · Occupational HealthTaxonomy 363LX0106X · License CNP201144 (ME)
360 BROADWAY, Bangor, ME 04401

Secondary Practice Locations 7

Location 110 Washington StWaterville, ME 04901-4315 · Phone (207) 861-5731 · Fax (207) 275-4897
Location 219 North StPresque Isle, ME 04769-2240 · Phone (207) 768-4568 · Fax (207) 764-6459
Location 3125 Main StPittsfield, ME 04967-4364 · Phone (207) 487-3726
Location 4360 BroadwayBangor, ME 04401-3979 · Phone (207) 907-1155 · Fax (207) 907-1888
Location 5195 Fore River PkwyPortland, ME 04102-2780 · Phone (207) 879-3466 · Fax (207) 879-3066
Location 632 Resort WayEllsworth, ME 04605-1717 · Phone (844) 975-4584
Location 7885 Union St Ste 215Bangor, ME 04401-3092 · Phone (207) 973-7380

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

Mrs. Jaclyn Kimberly Foraker Fnp-c 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 ID1658775531
PECOS Enrollment IDI20210816000230
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.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
129 services94 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
127 services114 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
30 services27 patients
Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) G0296
This visit involves discussing the necessity of a lung cancer screening using a low dose CT scan. It's a chance to determine if you're eligible for the test and to make an informed decision about proceeding. The scan can potentially detect lung cancer early, improving treatment outcomes.
26 services23 patients
Smoking and tobacco use intensive counseling, 4-10 minutes 99406
This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.
18 services14 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

St Joseph Hospital

Acute Care Hospitals · Bangor, ME
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number200001
Location360 BroadwayBangor, ME 04401 · Penobscot County
Emergency services

Northern Light Eastern Maine Medical Center

Acute Care Hospitals · Bangor, ME
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200033
Location489 State StreetBangor, ME 04401 · Penobscot County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04401 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
$82.58 typical visit price
range $53.26 – $162.77
Typical copayment $20.64 (range $13.31 – $40.69)
Most-billed visit code 99203
Established Patient
$94.60 typical visit price
range $16.90 – $132.79
Typical copayment $23.65 (range $4.22 – $33.19)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality91.11
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
3 suppliers19 claims21 services$7.70 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers31 claims31 services$98.82 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
5 suppliers12 claims3,976 services$0.03 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
4 suppliers12 claims1,230 services$0.10 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
7 suppliers22 claims22 services$25.38 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Emergency Medicine
360 BROADWAY
BANGOR, ME 04401
Registered Nurse
360 BROADWAY
BANGOR, ME 04401
Anesthesiology
360 BROADWAY
BANGOR, ME 04401
Emergency Medicine
360 BROADWAY
BANGOR, ME 04401
Surgery
360 BROADWAY
BANGOR, ME 04401
Specialist
360 BROADWAY
BANGOR, ME 04401
Internal Medicine (Pulmonary Disease)
360 BROADWAY
BANGOR, ME 04401
Internal Medicine (Cardiovascular Disease)
360 BROADWAY
BANGOR, ME 04401

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaclyn Foraker's NPI number?

The NPI number for Jaclyn Foraker is 1073139465. It was assigned to this individual provider in the NPPES registry on June 22, 2020.

Where is Jaclyn Foraker located?

Jaclyn Foraker practices at 360 Broadway, Bangor, ME 04401. The listed phone number is (207) 907-1155.

What is Jaclyn Foraker's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jaclyn Foraker enrolled in Medicare?

Yes. Jaclyn Foraker is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Jaclyn Foraker affiliated with any hospitals?

According to CMS data, Jaclyn Foraker is affiliated with St Joseph Hospital and Northern Light Eastern Maine Medical Center.

When was this NPI record last updated?

The NPPES record for Jaclyn Foraker was last updated on February 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.