JAMIE THACKER
NPI 1548998131
Nurse Practitioner - Family in Mishawaka, IN

Q: What is Jamie Thacker's NPI number?

The NPI number for Jamie Thacker is 1548998131. It was assigned to this individual provider in the NPPES registry on August 11, 2022.

Q: What is Jamie Thacker'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 Jamie Thacker was last updated on November 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 August 11, 2022PECOS EnrolledAccepts Medicare Assignment

4630 VISTULA RD, MISHAWAKA, IN 46544(574) 647-1900(574) 647-7289 Get Directions Write a Review

NPPES record last updated: November 30, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jamie Thacker NPPES

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

JAMIE THACKER (NPI 1548998131) is an individual family provider in Mishawaka, Indiana, licensed in Indiana (28202077A) and active in the NPI registry since August 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1548998131

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameJAMIE THACKER

Location Address4630 VISTULA RDMishawaka, IN 46544-4000

Mailing Address3245 Health Dr Ste 100Granger, IN 46530-1380 · (574) 647-2129

Phone(574) 647-1900

Fax(574) 647-7289

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateAugust 11, 2022

Last NPPES UpdateNovember 30, 2023

NPPES CertifiedNovember 30, 2023

✔ NPI 1548998131 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363LF0000X

License✔ Licensed in IN · 28202077A

4630 VISTULA RD, Mishawaka, IN 46544

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Other Identifiers 1

Medicaid300083152IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Jamie Thacker 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 ID244687606

PECOS Enrollment IDI20231107003523

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

51 services47 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

20 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46544 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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 7

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

BEACON MEDICAL GROUP, INC.

Family Medicine