JACOB PRINCE APRN
NPI 1124963608
Nurse Practitioner - Family in Lake City, FL

Q: What is Jacob Prince's NPI number?

The NPI number for Jacob Prince is 1124963608. It was assigned to this individual provider in the NPPES registry on April 21, 2026.

Q: What is Jacob Prince's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jacob Prince was last updated on June 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 April 21, 2026PECOS EnrolledAccepts Medicare Assignment

173 NW ALBRITTON LN, LAKE CITY, FL 32055(386) 755-4020(386) 752-9143 Get Directions Write a Review

NPPES record last updated: June 12, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Jacob Prince Aprn NPPES

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

JACOB PRINCE APRN (NPI 1124963608) is an individual family provider in Lake City, Florida, licensed in Florida (APRN11048113) and active in the NPI registry since April 2026. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1124963608

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameJACOB PRINCECredential: APRN

Location Address173 NW ALBRITTON LNLake City, FL 32055-4451

Mailing Address23476 Nw 186th AveHigh Springs, FL 32643-0673 · (386) 454-0698 · Fax (386) 454-0690

Phone(386) 755-4020

Fax(386) 752-9143

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateApril 21, 2026

Last NPPES UpdateJune 12, 2026

NPPES CertifiedJune 12, 2026

✔ NPI 1124963608 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 FL · APRN11048113

Also ListedRegistered NurseTaxonomy 163W00000X · License 9366609 (FL)

173 NW ALBRITTON LN, Lake City, FL 32055

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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 and accepts Medicare assignment

Jacob Prince Aprn 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 ID3577029081

PECOS Enrollment IDI20260724004271

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 Reassignment

Medicare enrollment records show Jacob Prince reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Trenton Medical Center, Inc.

Same address

Federally Qualified Health Center (FQHC)

173 NW ALBRITTON LN
Lake City, FL 32055

Reassigned Medicare billing, Florida enrollment
59 clinicians in this Medicare group

NPI 1124442355 (386) 755-4020

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32055 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 13

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

TRENTON MEDICAL CENTER, INC.

Clinic/Center (Federally Qualified Health Center (FQHC))