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DENISE JACKS ARNP
NPI 1104136738
Nurse Practitioner - Adult Health in Port Orange, FL

Active since October 17, 2010PECOS Enrolled
3691 CLYDE MORRIS BLVD, PORT ORANGE, FL 32129(386) 675-4411(866) 542-5859 Get Directions Write a Review

NPPES record last updated: January 16, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Denise Jacks Arnp NPPES

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

DENISE JACKS ARNP (NPI 1104136738) is an individual adult health provider in Port Orange, Florida, licensed in Florida (3017972) and active in the NPI registry since October 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104136738
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameDENISE JACKSCredential: ARNP
Location Address3691 CLYDE MORRIS BLVDPort Orange, FL 32129-2317
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(386) 675-4411
Fax(866) 542-5859
Sole ProprietorNo
Enumeration DateOctober 17, 2010
Last NPPES UpdateJanuary 16, 2025
NPPES CertifiedJanuary 16, 2025
✔ NPI 1104136738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in FL · 3017972
3691 CLYDE MORRIS BLVD, Port Orange, FL 32129
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Denise Jacks Arnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

3

Medicare enrollment records show Denise Jacks reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Vmd Primary Providers Central Florida PLLC
64 mi
Family Medicine
4501 13TH ST
Saint Cloud, FL 34769
  • Reassigned Medicare billing, Florida enrollment
  • 151 clinicians in this Medicare group
NPI 1134738974 (407) 798-8800
Magnolia Family Urgent Care, LLC
66 mi
Urgent Care
1490 SE MAGNOLIA EXT
Ocala, FL 34471
  • Reassigned Medicare billing, Florida enrollment
  • 6 clinicians in this Medicare group
NPI 1588038749 (352) 512-9703
Tulalip Tribes Of Washington
2,542 mi
Public Health & General Preventive Medicine
2821 MISSION HILL RD
Tulalip, WA 98271
  • Reassigned Medicare billing, Texas enrollment
  • 46 clinicians in this Medicare group
NPI 1013138924 (360) 716-4400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

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 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.
19 services18 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.
13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32129 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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 6

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

DR. PRADYUMANSINH M CHUDASAMA MD
Internal Medicine
3691 CLYDE MORRIS BLVD
PORT ORANGE, FL 32129
Volusia County (386) 675-4411
DR. CORETTA NICHELLE MURPHY M.D.
Internal Medicine
3691 CLYDE MORRIS BLVD
PORT ORANGE, FL 32129
Volusia County (386) 675-4411
EDWARD SUPINSKI MD
Internal Medicine
3691 CLYDE MORRIS BLVD
PORT ORANGE, FL 32129
Volusia County (386) 675-4411
MARIA C ROQUE ARNP
Nurse Practitioner (Family)
3691 CLYDE MORRIS BLVD
PORT ORANGE, FL 32129
Volusia County (386) 675-4411
DO YOON HWANG M.D.
Family Medicine
3691 CLYDE MORRIS BLVD
PORT ORANGE, FL 32129
Volusia County (386) 675-4410
LILIA DENEB VENTO VALVERDE APRN
Nurse Practitioner (Family)
3691 CLYDE MORRIS BLVD
PORT ORANGE, FL 32129
Volusia County (386) 675-4411

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 Denise Jacks's NPI number?

The NPI number for Denise Jacks is 1104136738. It was assigned to this individual provider in the NPPES registry on October 17, 2010.

Where is Denise Jacks located?

Denise Jacks practices at 3691 Clyde Morris Blvd, Port Orange, FL 32129. The listed phone number is (386) 675-4411.

What is Denise Jacks's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Denise Jacks enrolled in Medicare?

Yes. Denise Jacks is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Denise Jacks's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Denise Jacks reassigns Medicare benefits to 3 organizations: Vmd Primary Providers Central Florida PLLC (Saint Cloud, FL), Magnolia Family Urgent Care, LLC (Ocala, FL) and Tulalip Tribes Of Washington (Tulalip, WA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Denise Jacks's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Denise Jacks was last updated on January 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.