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JESSICA KIBACK APRN
NPI 1417414905
Nurse Practitioner - Women's Health in Hartford, CT

Active since February 21, 2019PECOS Enrolled
100 RETREAT AVE STE 201, HARTFORD, CT 06106(860) 246-8568(860) 493-7798 Get Directions Write a Review

NPPES record last updated: December 16, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 16, 2025, Feb 21, 2019 (2 updates tracked since 2019).

About Jessica Kiback Aprn NPPES

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

JESSICA KIBACK APRN (NPI 1417414905) is an individual women's health provider in Hartford, Connecticut, licensed in Connecticut (8136) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1417414905
Entity TypeIndividualFemale
Primary Taxonomy363LW0102X
Provider Legal NameJESSICA KIBACKCredential: APRN
Location Address100 RETREAT AVE STE 201Hartford, CT 06106-2528
Mailing Address100 Retreat Ave Ste 201Hartford, CT 06106-2528 · (860) 246-8568 · Fax (860) 493-7798
Phone(860) 246-8568
Fax(860) 493-7798
Sole ProprietorNo
Enumeration DateFebruary 21, 2019
Last NPPES UpdateDecember 16, 20252 updates tracked since enumeration
NPPES CertifiedDecember 16, 2025
✔ NPI 1417414905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LW0102X
Licenses✔ Licensed in CT · 8136✔ Licensed in CA · 12.008136
100 RETREAT AVE STE 201, Hartford, CT 06106
Open in Google Maps ↗

Secondary Practice Locations 3

Location 11084 Cromwell AveRocky Hill, CT 06067-3445 · Phone (860) 246-8568 · Fax (860) 493-7798
Location 2399 Farmington Ave Ste 230Farmington, CT 06032-1944 · Phone (860) 246-8568 · Fax (860) 493-7798
Location 3148 Eastern Blvd Ste 100Glastonbury, CT 06033-4321 · Phone (860) 246-8568 · Fax (860) 493-7798

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Kiback Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Jessica Kiback reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St. John's Community Health
2,422 mi
Community Health
82025 HIGHWAY 111, UNIT 101
Indio, CA 92201
  • Reassigned Medicare billing, California enrollment
  • 404 clinicians in this Medicare group
NPI 1609624980 (323) 541-1600

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06106 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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 4

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

ASHLEY GARCIA MD
Obstetrics & Gynecology
100 RETREAT AVE STE 201
HARTFORD, CT 06106
Capitol Planning Region (860) 246-8568
LEIGH THERESE KOWALSKI MD
Obstetrics & Gynecology
100 RETREAT AVE STE 201
HARTFORD, CT 06106
Capitol Planning Region (860) 246-8568
PALLVI KAUR SINGH DO
Obstetrics & Gynecology
100 RETREAT AVE STE 201
HARTFORD, CT 06106
Capitol Planning Region (860) 246-8567
MARLAINE JEAN-MILLER M.D
Obstetrics & Gynecology
100 RETREAT AVE STE 201
HARTFORD, CT 06106
Capitol Planning Region (860) 246-8568

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 Jessica Kiback's NPI number?

The NPI number for Jessica Kiback is 1417414905. It was assigned to this individual provider in the NPPES registry on February 21, 2019.

Where is Jessica Kiback located?

Jessica Kiback practices at 100 Retreat Ave Ste 201, Hartford, CT 06106. The listed phone number is (860) 246-8568.

What is Jessica Kiback's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

Is Jessica Kiback enrolled in Medicare?

Yes. Jessica Kiback is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jessica Kiback's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Kiback reassigns Medicare benefits to St. John's Community Health (Indio, CA). The 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 Jessica Kiback's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jessica Kiback accept?

Health plans from Anthem Blue Cross and Blue Shield list Jessica Kiback 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.

When was this NPI record last updated?

The NPPES record for Jessica Kiback was last updated on December 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.