JESSICA KAVANAUGH NP
NPI 1629553870
Nurse Practitioner - Family in Washington, IN

Active since October 03, 2018Opted out of Medicare · through Oct 1, 2027
102 E VAN TREES ST, WASHINGTON, IN 47501(812) 617-6005(812) 286-5009 Get Directions Write a Review

NPPES record last updated: January 20, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 20, 2023, Jan 2, 2021, Oct 3, 2018 (3 updates tracked since 2018).

About Jessica Kavanaugh Np NPPES

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

JESSICA KAVANAUGH NP (NPI 1629553870) is an individual family provider in Washington, Indiana, licensed in Indiana (28209245A) and active in the NPI registry since October 2018. She has opted out of Medicare through October 1, 2027.

NPPES Registry Identity

NPI1629553870
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJESSICA KAVANAUGHCredential: NP
Location Address102 E VAN TREES STWashington, IN 47501-2943
Mailing Address102 E Van Trees StWashington, IN 47501-2943 · (812) 617-6005 · Fax (812) 286-5009
Fax(812) 286-5009
Sole ProprietorNo
Enumeration DateOctober 3, 2018
Last NPPES UpdateJanuary 20, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 20, 2023
NPI 1629553870 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 · 28209245A
102 E VAN TREES ST, Washington, IN 47501

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Jessica Kavanaugh Np has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2023 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2023
Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47501 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 5

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

Chiropractor
102 E VAN TREES ST
WASHINGTON, IN 47501
Chiropractor
102 E VAN TREES ST
WASHINGTON, IN 47501
Chiropractor
102 E VAN TREES ST
WASHINGTON, IN 47501
Occupational Therapy Assistant
102 E VAN TREES ST
WASHINGTON, IN 47501
Clinic/Center
102 E VAN TREES ST
WASHINGTON, IN 47501

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629553870, enumerated as an "individual" on October 03, 2018.

The provider is located at 102 E VAN TREES ST WASHINGTON, IN 47501 and the phone number is (812) 617-6005.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

The provider might be accepting Accepts: CareSource. Please consult your insurance carrier or call the provider to verify.