BECKY A JACKS
NPI 1245911767
Nurse Practitioner - Psychiatric/Mental Health in Waldorf, MD
About Becky A Jacks NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BECKY A JACKS (NPI 1245911767) is an individual psychiatric/mental health provider in Waldorf, Maryland, licensed in Maryland (R232693) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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
Becky A Jacks 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.
Medicare Billing Reassignments
2Medicare enrollment records show Becky Jacks reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Camp Springs, MD 20746
- Reassigned Medicare billing, District of Columbia enrollment
- 6 clinicians in this Medicare group
Miami, FL 33130
- Reassigned Medicare billing, District of Columbia enrollment
- 1,424 clinicians in this Medicare group
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 20602 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
WALDORF, MD 20602
WALDORF, MD 20602
WALDORF, MD 20602
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 Becky Jacks's NPI number?
The NPI number for Becky Jacks is 1245911767. It was assigned to this individual provider in the NPPES registry on July 27, 2023.
Where is Becky Jacks located?
Becky Jacks practices at 11100 Billingsley Rd, Waldorf, MD 20602. The listed phone number is (301) 357-4199.
What is Becky Jacks's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Becky Jacks enrolled in Medicare?
Yes. Becky Jacks 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.
Which organizations bill Medicare for Becky Jacks's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Becky Jacks reassigns Medicare benefits to 2 organizations: Kirstin's Haven, Inc (Camp Springs, MD) and Grow Healthcare Group PA (Miami, FL). 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 Becky 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 Becky Jacks was last updated on July 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Becky A Jacks · NPI 1245911767
Psychiatric/Mental Health physician in Waldorf, Maryland. Individual provider, active in the CMS NPPES registry since July 27, 2023.
## Identity
- **NPI:** 1245911767 (Entity type: Individual)
- **Enumerated:** July 27, 2023
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** R232693 (Maryland)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 11100 BILLINGSLEY RD, Waldorf, MD 20602-3400
- **Phone:** (301) 357-4199
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Kirstin's Haven, Inc (NPI 1225585136, Camp Springs, MD); Grow Healthcare Group PA (NPI 1245845932, Miami, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** July 27, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1245911767) · Data from the CMS NPPES public registry.