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JACQUELINE IDUN NP
NPI 1659903045
Nurse Practitioner - Family in Antioch, CA

Active since February 04, 2020PECOS Enrolled
2213 BUCHANAN RD STE 103, ANTIOCH, CA 94509(925) 303-4780 Get Directions Write a Review

NPPES record last updated: April 6, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 6, 2020, Mar 5, 2020, Feb 4, 2020 (3 updates tracked since 2020).

About Jacqueline Idun Np NPPES

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

JACQUELINE IDUN NP (NPI 1659903045) is an individual family provider in Antioch, California, licensed in California (95014031) and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1659903045
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJACQUELINE IDUNCredential: NP
Location Address2213 BUCHANAN RD STE 103Antioch, CA 94509-4265
Mailing Address2213 Buchanan Rd Ste 103Antioch, CA 94509-4265
Phone(925) 303-4780
Sole ProprietorNo
Enumeration DateFebruary 4, 2020
Last NPPES UpdateApril 6, 20203 updates tracked since enumeration
NPPES CertifiedApril 6, 2020
✔ NPI 1659903045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95014031
Also ListedRegistered NurseTaxonomy 163W00000X · License 95071879 (CA)
2213 BUCHANAN RD STE 103, Antioch, CA 94509
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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)

Jacqueline Idun Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 94509 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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 3

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

JOSIE LAUREN BASS DE LA GUARDIA NP
Family Medicine
2213 BUCHANAN RD STE 103
ANTIOCH, CA 94509
Contra Costa County (925) 303-4780
BRIGHTER BEGINNINGS
Clinic/Center (Federally Qualified Health Center (FQHC))
2213 BUCHANAN RD STE 103
ANTIOCH, CA 94509
Contra Costa County (925) 303-4780
DR. JAMES H KRAVETZ DO
Family Medicine
2213 BUCHANAN RD STE 103
ANTIOCH, CA 94509
Contra Costa County (925) 303-4780

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 Jacqueline Idun's NPI number?

The NPI number for Jacqueline Idun is 1659903045. It was assigned to this individual provider in the NPPES registry on February 4, 2020.

Where is Jacqueline Idun located?

Jacqueline Idun practices at 2213 Buchanan Rd Ste 103, Antioch, CA 94509. The listed phone number is (925) 303-4780.

What is Jacqueline Idun's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jacqueline Idun enrolled in Medicare?

Yes. Jacqueline Idun is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacqueline Idun was last updated on April 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.