JACLYN M NIETZER PA
NPI 1417290586
Physician Assistant - Surgical in Orlando, FL

Q: What is Jaclyn Nietzer's NPI number?

The NPI number for Jaclyn Nietzer is 1417290586. It was assigned to this individual provider in the NPPES registry on March 27, 2013.

Q: What is Jaclyn Nietzer's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Jaclyn Nietzer was last updated on July 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 March 27, 2013PECOS EnrolledAccepts Medicare Assignment

1222 S ORANGE AVE, ORLANDO, FL 32806(321) 841-6444(407) 650-1307 Get Directions Write a Review

NPPES record last updated: July 27, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 27, 2022, Feb 9, 2022, Nov 11, 2015 (3 updates tracked since 2015).

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About Jaclyn M Nietzer Pa NPPES

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

JACLYN M NIETZER PA (NPI 1417290586) is an individual surgical provider in Orlando, Florida, licensed in Florida (PA9107172) and active in the NPI registry since March 2013. She is enrolled in Medicare PECOS, is affiliated with Orlando Health, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1417290586

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameJACLYN M NIETZERCredential: PA

Location Address1222 S ORANGE AVEOrlando, FL 32806-1215

Mailing Address1414 Kuhl Ave # Mp38Orlando, FL 32806-2008 · (321) 842-4713

Phone(321) 841-6444

Fax(407) 650-1307

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateMarch 27, 2013

Last NPPES UpdateJuly 27, 20223 updates tracked since enumeration

NPPES CertifiedJuly 27, 2022

✔ NPI 1417290586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in FL · PA9107172

1222 S ORANGE AVE, Orlando, FL 32806

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Other Identifiers 1

Medicaid008573600FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, AvMed.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

Jaclyn M Nietzer Pa 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 ID3173769171

PECOS Enrollment IDI20130417000645

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.

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.

Harvest of vein using an endoscope 33508

Harvesting a vein using an endoscope is a procedure where a small camera is used to help surgeons remove a vein from your body. This vein is often used to bypass a blocked artery, improving blood flow to your heart.

11 services11 patients

Coronary artery bypass using artery graft, 1 graft 33533

A coronary artery bypass with one artery graft is a surgical procedure to improve blood flow to your heart. An artery from another part of your body is used to bypass a blocked or narrowed coronary artery. This can help reduce chest pain and risk of heart attack.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Orlando Health

Acute Care Hospitals · Orlando, FL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100006

Location52 W Underwood StOrlando, FL 32806 · Orange County

Emergency services Birthing friendly

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.

BRYAN DAVID BROWN MD

Orthopaedic Surgery (Hand Surgery)

1222 S ORANGE AVE, 5TH FLOOR
ORLANDO, FL 32806

Orange County (321) 841-1764

KAREN LEONIA WALKER M.D.

Thoracic Surgery (Cardiothoracic Vascular Surgery)