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STEPHANIE A. JACKOVICH NP
NPI 1265747570
Nurse Practitioner - Neonatal in Indianapolis, IN

Active since August 11, 2010PECOS Enrolled
705 RILEY HOSPITAL DR, RR 208, INDIANAPOLIS, IN 46202(317) 274-4715(317) 274-2065 Get Directions Write a Review

NPPES record last updated: December 7, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Stephanie A. Jackovich Np NPPES

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

STEPHANIE A. JACKOVICH NP (NPI 1265747570) is an individual neonatal provider in Indianapolis, Indiana, licensed in Indiana (71003307) and active in the NPI registry since August 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265747570
Entity TypeIndividualFemale
Primary Taxonomy363LN0000X
Provider Legal NameSTEPHANIE A. JACKOVICHCredential: NP
Location Address705 RILEY HOSPITAL DR, RR 208Indianapolis, IN 46202-5109
Mailing AddressPo Box 1026Indianapolis, IN 46206-1026 · (317) 274-1201 · Fax (317) 278-9905
Phone(317) 274-4715
Fax(317) 274-2065
Sole ProprietorNo
Enumeration DateAugust 11, 2010
Last NPPES UpdateDecember 7, 2023
NPPES CertifiedDecember 7, 2023
✔ NPI 1265747570 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · NeonatalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LN0000X
Licenses✔ Licensed in IN · 71003307✔ Licensed in IN · 28164413
705 RILEY HOSPITAL DR, Indianapolis, IN 46202
Open in Google Maps ↗

Other Identifiers 1

Medicaid201040340IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stephanie A. Jackovich Np 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

2

Medicare enrollment records show Stephanie Jackovich reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm
1,457 mi
Public Health or Welfare
2400 W DATSI ST
Camp Verde, AZ 86322
  • Reassigned Medicare billing, Texas enrollment
  • 599 clinicians in this Medicare group
NPI 1205859618 (928) 567-2168
Maricopa County Special Health Care District
1,485 mi
Adult Mental Health
950 E MAIN ST
Mesa, AZ 85203
  • Reassigned Medicare billing, Arizona enrollment
  • 285 clinicians in this Medicare group
NPI 1104331115 (602) 655-6260

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 46202 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.

MOHANNAD MOALLEM M.D.
Pediatrics (Neonatal-Perinatal Medicine)
705 RILEY HOSPITAL DR
INDIANAPOLIS, IN 46202
Marion County (317) 274-4779
TIA IMHOFF MCGEE FNP-BC
Nurse Practitioner (Family)
705 RILEY HOSPITAL DR
INDIANAPOLIS, IN 46202
Marion County (317) 312-2204
JOSHUA WAYNE GOLLUB
Pediatrics (Neonatal-Perinatal Medicine)
705 RILEY HOSPITAL DR
INDIANAPOLIS, IN 46202
Marion County (317) 274-4779
NOAH MENAKER DDS
Dentist (Pediatric Dentistry)
705 RILEY HOSPITAL DR
INDIANAPOLIS, IN 46202
Marion County (317) 944-3865
DR. ANAS NADER ATA ALJABARI MBBS
Student in an Organized Health Care Education/Training Program
705 RILEY HOSPITAL DR
INDIANAPOLIS, IN 46202
Marion County (856) 398-9630
TALIA RAE BOOHER MB BCH BAO
Student in an Organized Health Care Education/Training Program
705 RILEY HOSPITAL DR
INDIANAPOLIS, IN 46202
Marion County (317) 944-7571
JANET R SHAVER NP
Nurse Practitioner (Pediatrics)
705 RILEY HOSPITAL DR, RI 1601
INDIANAPOLIS, IN 46202
Marion County (317) 944-4842
UNIVERSITY PEDIATRIC DENTISTRY ASSOCIATES
Dentist (Pediatric Dentistry)
705 RILEY HOSPITAL DR, ROC - SUITE 4205
INDIANAPOLIS, IN 46202
Marion County (317) 944-9604

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 Stephanie Jackovich's NPI number?

The NPI number for Stephanie Jackovich is 1265747570. It was assigned to this individual provider in the NPPES registry on August 11, 2010.

Where is Stephanie Jackovich located?

Stephanie Jackovich practices at 705 Riley Hospital Dr Rr 208, Indianapolis, IN 46202. The listed phone number is (317) 274-4715.

What is Stephanie Jackovich's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, with taxonomy code 363LN0000X.

Is Stephanie Jackovich enrolled in Medicare?

Yes. Stephanie Jackovich is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Stephanie Jackovich's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stephanie Jackovich reassigns Medicare benefits to 2 organizations: Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm (Camp Verde, AZ) and Maricopa County Special Health Care District (Mesa, AZ). 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 Stephanie Jackovich's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Stephanie Jackovich accept?

Health plans from Ambetter from Arizona Complete Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc and Imperial Insurance Companies, Inc. and 1 other insurer list Stephanie Jackovich as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Stephanie Jackovich was last updated on December 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.