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MS. TATIANA ELLEN JAACKS PA
NPI 1295622553
Physician Assistant in Goodyear, AZ

Active since June 19, 2025PECOS Enrolled
14455 W VAN BUREN ST # 100, GOODYEAR, AZ 85338(248) 410-4704 Get Directions Write a Review

NPPES record last updated: August 2, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ms. Tatiana Ellen Jaacks Pa NPPES

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

MS. TATIANA ELLEN JAACKS PA (NPI 1295622553) is an individual physician assistant in Goodyear, Arizona and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1295622553
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. TATIANA ELLEN JAACKSCredential: PA
Location Address14455 W VAN BUREN ST # 100Goodyear, AZ 85338-9209
Mailing Address14455 W Van Buren St # 100Goodyear, AZ 85338-9209
Phone(248) 410-4704
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateJune 19, 2025
Last NPPES UpdateAugust 2, 2025
NPPES CertifiedAugust 2, 2025
✔ NPI 1295622553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
14455 W VAN BUREN ST # 100, Goodyear, AZ 85338
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Tatiana Ellen Jaacks Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951886068
PECOS Enrollment IDI20260326003029
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 85338 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
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 10

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

KAFILAT SUMON
Student in an Organized Health Care Education/Training Program
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (713) 825-8551
LEXADY BURKE LONGFIELD PA-C
Physician Assistant
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (623) 518-2386
JOYCE AIYED BOTROS
Physician Assistant
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (949) 463-6909
HANA ALSADI
Student in an Organized Health Care Education/Training Program
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (623) 518-2386
JAEWAN KIM
Physician Assistant
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (623) 518-2386
HEATHER TAMERA DIAMOND
Student in an Organized Health Care Education/Training Program
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (623) 518-2386
ELMIRA ALITABAR
Student in an Organized Health Care Education/Training Program
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (406) 671-7970
ELISE WEIR
Student in an Organized Health Care Education/Training Program
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (952) 454-8721

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 Tatiana Jaacks's NPI number?

The NPI number for Tatiana Jaacks is 1295622553. It was assigned to this individual provider in the NPPES registry on June 19, 2025.

Where is Tatiana Jaacks located?

Tatiana Jaacks practices at 14455 W Van Buren St # 100, Goodyear, AZ 85338. The listed phone number is (248) 410-4704.

What is Tatiana Jaacks's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Tatiana Jaacks enrolled in Medicare?

Yes. Tatiana Jaacks is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tatiana Jaacks was last updated on August 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.