RILEY JACKO NP-C
NPI 1477356616
Nurse Practitioner in San Juan Capistrano, CA

Q: What is Riley Jacko's NPI number?

The NPI number for Riley Jacko is 1477356616. It was assigned to this individual provider in the NPPES registry on March 31, 2025.

Q: What is Riley Jacko's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Riley Jacko was last updated on March 31, 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 31, 2025PECOS Enrolled

30230 RANCHO VIEJO RD STE 134, SAN JUAN CAPISTRANO, CA 92675(949) 503-1414 Get Directions Write a Review

NPPES record last updated: March 31, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Riley Jacko Np-c NPPES

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

RILEY JACKO NP-C (NPI 1477356616) is an individual nurse practitioner in San Juan Capistrano, California, licensed in California (95034510) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1477356616

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameRILEY JACKOCredential: NP-C

Location Address30230 RANCHO VIEJO RD STE 134San Juan Capistrano, CA 92675-1585

Mailing Address30230 Rancho Viejo Rd Ste 134San Juan Capistrano, CA 92675-1585

Phone(949) 503-1414

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateMarch 31, 2025

NPPES CertifiedMarch 31, 2025

✔ NPI 1477356616 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in CA · 95034510

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

30230 RANCHO VIEJO RD STE 134, San Juan Capistrano, CA 92675

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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)

Riley Jacko Np-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3870085616

PECOS Enrollment IDI20251119004644

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 92675 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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 5

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

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