DR. JACQUELYN GERALDINE SMALL DO
NPI 1225694102
Family Medicine in Fort Wayne, IN

Q: What is Jacquelyn Small's NPI number?

The NPI number for Jacquelyn Small is 1225694102. It was assigned to this individual provider in the NPPES registry on May 15, 2019.

Q: What is Jacquelyn Small's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Jacquelyn Small was last updated on September 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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 May 15, 2019PECOS EnrolledAccepts Medicare Assignment

3909 NEW VISION DR, FORT WAYNE, IN 46845(260) 469-6610(260) 969-3065 Get Directions Write a Review

NPPES record last updated: September 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 3, 2024, Jul 11, 2024, May 15, 2023 and 4 more (7 updates tracked since 2019).

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About Dr. Jacquelyn Geraldine Small Do NPPES

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

DR. JACQUELYN GERALDINE SMALL DO (NPI 1225694102) is an individual family medicine provider in Fort Wayne, Indiana, licensed in Indiana (02007766A) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, is affiliated with Parkview Regional Medical Center, and is a graduate of Michigan State University College Of Osteopathic Medicine (2019).

NPPES Registry Identity

NPI1225694102

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. JACQUELYN GERALDINE SMALLCredential: DO

Location Address3909 NEW VISION DRFort Wayne, IN 46845-1725

Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701

Phone(260) 469-6610

Fax(260) 969-3065

Sole ProprietorNo

Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 2019

Enumeration DateMay 15, 2019

Last NPPES UpdateSeptember 3, 20247 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2024

✔ NPI 1225694102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in IN · 02007766A✔ Licensed in MI · 5101025847

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

3909 NEW VISION DR, Fort Wayne, IN 46845

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Dr. Jacquelyn Geraldine Small Do 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 ID3476889874

PECOS Enrollment IDI20240726002587

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 5

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 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.

104 services95 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.

74 services50 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

38 services34 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

27 services27 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

21 services20 patients

Hospital Affiliations CMS Care Compare

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

Parkview Regional Medical Center

Acute Care Hospitals · Fort Wayne, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150021

Location11109 Parkview Plaza DriveFort Wayne, IN 46845 · Allen County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46845 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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.

MCKENNA A GOTTFRIED

Nurse Practitioner