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

Active since March 31, 2025PECOS EnrolledAccepts Medicare Assignment
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: October 18, 2026.

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Riley Jacko Np-c 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 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.

Medicare Billing Reassignment

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

Newport Care Medical Group, Inc
17 mi
Orthopaedic Surgery
441 OLD NEWPORT BLVD
Newport Beach, CA 92663
  • Reassigned Medicare billing, California enrollment
  • 28 clinicians in this Medicare group
NPI 1528401783 (949) 491-9991

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 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 4

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

RENEW PC
Emergency Medicine
30230 RANCHO VIEJO RD STE 134
SAN JUAN CAPISTRANO, CA 92675
Orange County (949) 478-1411
EMILY VAN GILDER
Physician Assistant
30230 RANCHO VIEJO RD STE 134
SAN JUAN CAPISTRANO, CA 92675
Orange County (949) 436-4719
RENEW HEALTH MEDICAL CORPORATION
Emergency Medicine
30230 RANCHO VIEJO RD STE 134
SAN JUAN CAPISTRANO, CA 92675
Orange County (949) 503-1414
TANYA DALL MD
Emergency Medicine
30230 RANCHO VIEJO RD STE 134
SAN JUAN CAPISTRANO, CA 92675
Orange County (949) 702-6736

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 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.

Where is Riley Jacko located?

Riley Jacko practices at 30230 Rancho Viejo Rd Ste 134, San Juan Capistrano, CA 92675. The listed phone number is (949) 503-1414.

What is Riley Jacko's specialty?

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

Is Riley Jacko enrolled in Medicare?

Yes. Riley Jacko is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Riley Jacko's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Riley Jacko reassigns Medicare benefits to Newport Care Medical Group, Inc (Newport Beach, 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 Riley Jacko's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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 18 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.