RETUNDA JACKSON- PHIFFER
NPI 1285469148
Nurse Practitioner - Psychiatric/Mental Health in Granite City, IL

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.

Active since September 02, 2024PECOS EnrolledAccepts Medicare Assignment

2166 MADISON AVE, GRANITE CITY, IL 62040(618) 452-3301 Get Directions Write a Review

NPPES record last updated: November 6, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 6, 2024, Sep 2, 2024 (2 updates tracked since 2024).

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About Retunda Jackson- Phiffer NPPES

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

RETUNDA JACKSON- PHIFFER (NPI 1285469148) is an individual psychiatric/mental health provider in Granite City, Illinois, licensed in Illinois (209030994) and active in the NPI registry since September 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1285469148

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameRETUNDA JACKSON- PHIFFER

Location Address2166 MADISON AVEGranite City, IL 62040-4700

Mailing Address201 Todd LnBelleville, IL 62221-5751

Phone(618) 452-3301

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateSeptember 2, 2024

Last NPPES UpdateNovember 6, 20242 updates tracked since enumeration

NPPES CertifiedNovember 6, 2024

✔ NPI 1285469148 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in IL · 209030994

2166 MADISON AVE, Granite City, IL 62040

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware 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

Retunda Jackson- Phiffer 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 ID5890219927

PECOS Enrollment IDI20250409003643

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 62040 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

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$99.71 typical visit price

range $17.51 – $139.99

Typical copayment $24.92 (range $4.37 – $34.99)

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 15

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

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