MRS. JENNIFER ELAINE NYDAM R.N., C.N.M.
NPI 1407958432
Advanced Practice Midwife in Ft Defiance, AZ

Q: What is Jennifer Nydam's NPI number?

The NPI number for Jennifer Nydam is 1407958432. It was assigned to this individual provider in the NPPES registry on September 1, 2006.

Q: What is Jennifer Nydam's specialty?

The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Nydam was last updated on October 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since September 01, 2006PECOS EnrolledAccepts Medicare Assignment

CORNER OF ROUTE N12 AND N7, FT DEFIANCE, AZ 86504(928) 729-8000 Get Directions Write a Review

NPPES record last updated: October 16, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Mrs. Jennifer Elaine Nydam R.n., C.n.m. NPPES

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

MRS. JENNIFER ELAINE NYDAM R.N., C.N.M. (NPI 1407958432) is an individual advanced practice midwife in Ft Defiance, Arizona, licensed in New Mexico (773) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1407958432

Entity TypeIndividualFemale

Primary Taxonomy367A00000X

Provider Legal NameMRS. JENNIFER ELAINE NYDAMCredential: R.N., C.N.M.

Location AddressCORNER OF ROUTE N12 AND N7Ft Defiance, AZ 86504-0649

Mailing Address808 E Green AveGallup, NM 87301-5513 · (707) 367-1977

Phone(928) 729-8000

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateSeptember 1, 2006

Last NPPES UpdateOctober 16, 2019

✔ NPI 1407958432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367A00000X

Licenses✔ Licensed in NM · 773✔ Licensed in CA · 1683

Definition

Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.

CORNER OF ROUTE N12 AND N7, Ft Defiance, AZ 86504

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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 and accepts Medicare assignment

Mrs. Jennifer Elaine Nydam R.n., C.n.m. 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 ID5698921484

PECOS Enrollment IDI20120810000061

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 86504 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.

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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.

DR. ROMULO LAURETA PARUNGAO M.D.

Emergency Medicine