KATHLEEN ADELE JACKSON AG-ACNP
NPI 1699108209
Nurse Practitioner - Acute Care in Saint Paul, MN

Q: What is Kathleen Jackson's NPI number?

The NPI number for Kathleen Jackson is 1699108209. It was assigned to this individual provider in the NPPES registry on August 19, 2013.

Q: What is Kathleen Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Kathleen Jackson was last updated on September 25, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 19, 2013PECOS EnrolledAccepts Medicare Assignment

1700 UNIVERSITY AVE W FL 6, SAINT PAUL, MN 55104(651) 232-2273 Get Directions Write a Review

NPPES record last updated: September 25, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 25, 2018, Sep 30, 2015 (2 updates tracked since 2015).

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About Kathleen Adele Jackson Ag-acnp NPPES

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

KATHLEEN ADELE JACKSON AG-ACNP (NPI 1699108209) is an individual acute care provider in Saint Paul, Minnesota, licensed in Minnesota (R-169854-7) and active in the NPI registry since August 2013. She is enrolled in Medicare PECOS, is affiliated with North Memorial Health Hospital, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1699108209

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameKATHLEEN ADELE JACKSONCredential: AG-ACNP

Location Address1700 UNIVERSITY AVE W FL 6Saint Paul, MN 55104-3727

Mailing Address5036 Logan Ave SMinneapolis, MN 55419-1018 · (612) 963-8189

Phone(651) 232-2273

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateAugust 19, 2013

Last NPPES UpdateSeptember 25, 20182 updates tracked since enumeration

✔ NPI 1699108209 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in MN · R-169854-7

1700 UNIVERSITY AVE W FL 6, Saint Paul, MN 55104

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica, Sanford Health Plan.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

Kathleen Adele Jackson Ag-acnp 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 ID345474581

PECOS Enrollment IDI20131002000089

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.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

225 services79 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

15 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

North Memorial Health Hospital

Acute Care Hospitals · Robbinsdale, MN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240001

Location3300 Oakdale NorthRobbinsdale, MN 55422 · Hennepin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55104 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

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 19

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

MEGAN LIFTO APRN, CNS

Clinical Nurse Specialist