MR. JACK C VAN LUYN RN, NP-C
NPI 1679828131
Nurse Practitioner - Family in Tripler Army Medical Center, HI
About Mr. Jack C Van Luyn Rn, Np-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. JACK C VAN LUYN RN, NP-C (NPI 1679828131) is an individual family provider in Tripler Army Medical Center, Hawaii, licensed in Washington (RN00162839) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Jack C Van Luyn Rn, Np-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Jack Van Luyn reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Dallas, TX 75244
- Reassigned Medicare billing, Hawaii enrollment
- 59 clinicians in this Medicare group
Dallas, TX 75244
- Reassigned Medicare billing, Washington enrollment
- 317 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 96859 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
TRIPLER ARMY MEDICAL CENTER, HI 96859
TRIPLER ARMY MEDICAL CENTER, HI 96859
TRIPLER AMC, HI 96859
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 Jack Van Luyn's NPI number?
The NPI number for Jack Van Luyn is 1679828131. It was assigned to this individual provider in the NPPES registry on July 19, 2012.
Where is Jack Van Luyn located?
Jack Van Luyn practices at 1 Jarrett White Rd, Tripler Army Medical Center, HI 96859. The listed phone number is (808) 433-2600.
What is Jack Van Luyn's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jack Van Luyn enrolled in Medicare?
Yes. Jack Van Luyn is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Jack Van Luyn's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jack Van Luyn reassigns Medicare benefits to 2 organizations: Signify Health, LLC (Dallas, TX) and Signify Health Medical Associates, PLLC (Dallas, TX). 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 Jack Van Luyn'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 Jack Van Luyn was last updated on July 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Mr. Jack C Van Luyn, RN, NP-C · NPI 1679828131
Family physician in Tripler Army Medical Center, Hawaii. Individual provider, active in the CMS NPPES registry since July 19, 2012.
## Identity
- **NPI:** 1679828131 (Entity type: Individual)
- **Enumerated:** July 19, 2012
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** RN00162839 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 1 JARRETT WHITE RD, Tripler Army Medical Center, HI 96859-5001
- **Phone:** (808) 433-2600
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Signify Health, LLC (NPI 1689158487, Dallas, TX); Signify Health Medical Associates, PLLC (NPI 1750845863, Dallas, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** July 19, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1679828131) · Data from the CMS NPPES public registry.