DIANA L JACKSON AGACNP
NPI 1417498007
Nurse Practitioner - Family in Lewiston, ME

Q: What is Diana Jackson's NPI number?

The NPI number for Diana Jackson is 1417498007. It was assigned to this individual provider in the NPPES registry on March 15, 2017.

Q: What is Diana Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Diana Jackson was last updated on March 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since March 15, 2017PECOS Enrolled

300 MAIN ST, LEWISTON, ME 04240(207) 795-7575(207) 795-7133 Get Directions Write a Review

NPPES record last updated: March 24, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 24, 2025, Mar 15, 2017 (2 updates tracked since 2017).

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About Diana L Jackson Agacnp NPPES

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

DIANA L JACKSON AGACNP (NPI 1417498007) is an individual family provider in Lewiston, Maine, licensed in Maine (CNP171007) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS and maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1417498007

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameDIANA L JACKSONCredential: AGACNP

Location Address300 MAIN STLewiston, ME 04240-7027

Mailing Address300 Main StLewiston, ME 04240-7027 · (207) 795-7575 · Fax (207) 795-7133

Phone(207) 795-7575

Fax(207) 795-7133

Sole ProprietorNo

Enumeration DateMarch 15, 2017

Last NPPES UpdateMarch 24, 20252 updates tracked since enumeration

NPPES CertifiedMarch 24, 2025

✔ NPI 1417498007 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in ME · CNP171007

Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X · License CNP171007 (ME)

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License CNP171007 (ME)

300 MAIN ST, Lewiston, ME 04240

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Secondary Practice Location 1

Location 1887 Congress St Ste 400Portland, ME 04102-3163 · Phone (207) 774-6368 · Fax (207) 774-9388

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Diana L Jackson Agacnp 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.

Areas of Expertise CMS Part B claims

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

39 services25 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04240 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

$82.58 typical visit price

range $53.26 – $162.77

Typical copayment $20.64 (range $13.31 – $40.69)

Most-billed visit code 99203

Established Patient

$94.60 typical visit price

range $16.90 – $132.79

Typical copayment $23.65 (range $4.22 – $33.19)

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 20

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

ANGELA WOOD CRNA

Nurse Anesthetist, Certified Registered

300 MAIN ST, CENTRAL MAINE MEDICAL CENTER
LEWISTON, ME 04240

Androscoggin County (207) 795-0111

DANA MCCOY PT

Physical Therapist