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EMILY JACK MD
NPI 1275197691
Family Medicine in Heppner, OR

Active since May 01, 2019PECOS EnrolledAccepts Medicare Assignment
130 THOMPSON ST, HEPPNER, OR 97836(541) 676-5504(541) 676-8247 Get Directions Write a Review

NPPES record last updated: December 2, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 2, 2025, May 1, 2019 (2 updates tracked since 2019).

About Emily Jack Md NPPES

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

EMILY JACK MD (NPI 1275197691) is an individual family medicine provider in Heppner, Oregon, licensed in Oregon (MD211954) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, is affiliated with Pioneer Memorial Hospital (heppner), and is a graduate of Oregon Health Sciences University School Of Medicine (2019).

NPPES Registry Identity

NPI1275197691
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameEMILY JACKCredential: MD
Location Address130 THOMPSON STHeppner, OR 97836-7325
Mailing AddressPo Box 9Heppner, OR 97836-0009 · (541) 676-5504 · Fax (541) 676-8247
Phone(541) 676-5504
Fax(541) 676-8247
Sole ProprietorNo
Medical School CMSOregon Health Sciences University School Of MedicineGraduated 2019
Enumeration DateMay 1, 2019
Last NPPES UpdateDecember 2, 20252 updates tracked since enumeration
NPPES CertifiedDecember 2, 2025
✔ NPI 1275197691 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OR · MD211954
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.
130 THOMPSON ST, Heppner, OR 97836
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Other Names 1

Former Name (1)Emily Thompson

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans 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 and accepts Medicare assignment

Emily Jack Md 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 ID6507193042
PECOS Enrollment IDI20221115002877
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

4

Medicare enrollment records show Emily Jack reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Morrow County Health District
0.1 mi
Critical Access
564 EAST PIONEER DRIVE
Heppner, OR 97836
  • Reassigned Medicare billing, Oregon enrollment
  • 31 clinicians in this Medicare group
NPI 1376572099 (541) 676-2925
County Of Morrow
0.2 mi
Public Health, State or Local
110 N COURT ST
Heppner, OR 97836
  • Reassigned Medicare billing, Oregon enrollment
NPI 1952302689 (541) 676-5421
Commonspirit Oregon
41 mi
Multi-Specialty
2801 ST ANTHONY WAY
Pendleton, OR 97801
  • Reassigned Medicare billing, Oregon enrollment
  • 19 clinicians in this Medicare group
NPI 1831169903 (541) 276-5121
Commonspirit Oregon
41 mi
Multi-Specialty
2801 ST ANTHONY WAY
Pendleton, OR 97801
  • Reassigned Medicare billing, Oregon enrollment
  • Medicare enrollment name: St Anthony Hospital
  • 34 clinicians in this Medicare group
NPI 1831169903 (541) 276-5121

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

Areas of Expertise CMS Part B claims 2

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.

Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
79 services79 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
79 services79 patients

Hospital Affiliations CMS Care Compare 3

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

Pioneer Memorial Hospital (heppner)

Critical Access Hospitals · Heppner, OR
OwnershipGovernment - Hospital District or Authority
CMS Certification Number381310
Location564 E Pioneer DriveHeppner, OR 97836 · Morrow County
Emergency services

St Anthony Hospital

Critical Access Hospitals · Pendleton, OR
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number381319
Location2801 St Anthony WayPendleton, OR 97801 · Umatilla County
Emergency services Birthing friendly

Good Shepherd Medical Center

Critical Access Hospitals · Hermiston, OR
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number381325
Location610 NW 11th StreetHermiston, OR 97838 · Umatilla County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97836 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
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$97.16 typical visit price
range $17.68 – $136.19
Typical copayment $24.29 (range $4.42 – $34.04)
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

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

DANIELLE MATELESKA PA-C
Physician Assistant
130 THOMPSON ST
HEPPNER, OR 97836
Morrow County (541) 676-5504

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 Emily Jack's NPI number?

The NPI number for Emily Jack is 1275197691. It was assigned to this individual provider in the NPPES registry on May 1, 2019. The provider is also known as Emily Thompson.

Where is Emily Jack located?

Emily Jack practices at 130 Thompson St, Heppner, OR 97836. The listed phone number is (541) 676-5504.

What is Emily Jack's specialty?

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

Is Emily Jack enrolled in Medicare?

Yes. Emily Jack 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 Emily Jack's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Emily Jack reassigns Medicare benefits to 4 organizations: Morrow County Health District (Heppner, OR), County Of Morrow (Heppner, OR), Commonspirit Oregon (Pendleton, OR) and Commonspirit Oregon (Pendleton, OR). 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 Emily Jack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Emily Jack accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Emily Jack 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.

Is Emily Jack affiliated with any hospitals?

According to CMS data, Emily Jack is affiliated with Pioneer Memorial Hospital (heppner), St Anthony Hospital and Good Shepherd Medical Center.

When was this NPI record last updated?

The NPPES record for Emily Jack was last updated on December 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.