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

Q: 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.

Q: What is Stephanie Jackovich's specialty?

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

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: August 09, 2026.

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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

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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, and ordering and referring status from the CMS PECOS system.

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.

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)