JACQUELYN SMITH-DOUGLAS FNP
NPI 1598336828
Nurse Practitioner in Costa Mesa, CA
About Jacquelyn Smith-douglas Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACQUELYN SMITH-DOUGLAS FNP (NPI 1598336828) is an individual nurse practitioner in Costa Mesa, California, licensed in California (F07210327) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Buena Park, and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
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
Jacquelyn Smith-douglas Fnp 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.
Medicare Billing Reassignments
7Medicare enrollment records show Jacquelyn Smith-douglas reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Irvine, CA 92604
- Reassigned Medicare billing, California enrollment
- 212 clinicians in this Medicare group
Whittier, CA 90605
- Reassigned Medicare billing, California enrollment
- 22 clinicians in this Medicare group
Corona, CA 92879
- Reassigned Medicare billing, California enrollment
- 32 clinicians in this Medicare group
Riverside, CA 92506
- Reassigned Medicare billing, California enrollment
- 19 clinicians in this Medicare group
Glendale, CA 91201
- Reassigned Medicare billing, California enrollment
- 23 clinicians in this Medicare group
Burbank, CA 91505
- Reassigned Medicare billing, California enrollment
- 236 clinicians in this Medicare group
El Cajon, CA 92020
- Reassigned Medicare billing, California enrollment
- 212 clinicians in this Medicare group
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 92626 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
COSTA MESA, CA 92626
COSTA MESA, CA 92626
COSTA MESA, CA 92626
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 Jacquelyn Smith-douglas's NPI number?
The NPI number for Jacquelyn Smith-douglas is 1598336828. It was assigned to this individual provider in the NPPES registry on July 7, 2021.
Where is Jacquelyn Smith-douglas located?
Jacquelyn Smith-douglas practices at 150 Paularino Ave, Costa Mesa, CA 92626. The listed phone number is (949) 556-3433.
What is Jacquelyn Smith-douglas's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Jacquelyn Smith-douglas enrolled in Medicare?
Yes. Jacquelyn Smith-douglas 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 organizations bill Medicare for Jacquelyn Smith-douglas's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacquelyn Smith-douglas reassigns Medicare benefits to 7 organizations: Minuteclinic Diagnostic Medical Group Of Orange County Inc (Irvine, CA), Onyx Medical Group Inc (Whittier, CA), Remedial Patients Care Inc (Corona, CA), Remedial Medical Services Inc (Riverside, CA), Vital Medical Group, Inc (Glendale, CA) and 2 more organizations, listed in the Medicare section above. Each 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 Jacquelyn Smith-douglas'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 Jacquelyn Smith-douglas was last updated on December 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Jacquelyn Smith-Douglas, FNP · NPI 1598336828
Nurse Practitioner physician in Costa Mesa, California. Individual provider, active in the CMS NPPES registry since July 7, 2021.
## Identity
- **NPI:** 1598336828 (Entity type: Individual)
- **Enumerated:** July 7, 2021
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** F07210327 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 150 PAULARINO AVE, Costa Mesa, CA 92626-3301
- **Phone:** (949) 556-3433
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 7 organizations under Medicare reassignment (form CMS-855R): Minuteclinic Diagnostic Medical Group Of Orange County Inc (NPI 1104013879, Irvine, CA); Onyx Medical Group Inc (NPI 1851191019, Whittier, CA); Remedial Patients Care Inc (NPI 1508507229, Corona, CA); Remedial Medical Services Inc (NPI 1083216998, Riverside, CA); Vital Medical Group, Inc (NPI 1124886437, Glendale, CA); and 2 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** December 29, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1598336828) · Data from the CMS NPPES public registry.