JACKIE FLOYD HAGENBAUMER
NPI 1710691274
Nurse Anesthetist, Certified Registered in Jacksonville, FL

Q: What is Jackie Hagenbaumer's NPI number?

The NPI number for Jackie Hagenbaumer is 1710691274. It was assigned to this individual provider in the NPPES registry on January 10, 2023.

Q: What is Jackie Hagenbaumer's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Active since January 10, 2023Accepts Medicare Assignment

655 W 8TH ST, JACKSONVILLE, FL 32209(904) 244-0411 Get Directions Write a Review

NPPES record last updated: January 10, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Jackie Floyd Hagenbaumer NPPES

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

JACKIE FLOYD HAGENBAUMER (NPI 1710691274) is an individual nurse anesthetist, certified registered in Jacksonville, Florida, licensed in Florida (11023863) and active in the NPI registry since January 2023. She is affiliated with Shands Jacksonville and is a graduate of Other (2022).

NPPES Registry Identity

NPI1710691274

Entity TypeIndividualFemale

Primary Taxonomy367500000X

Provider Legal NameJACKIE FLOYD HAGENBAUMER

Location Address655 W 8TH STJacksonville, FL 32209-6511

Mailing Address9479 Heckscher DrJacksonville, FL 32226-2420 · (352) 214-4761

Phone(904) 244-0411

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateJanuary 10, 2023

NPPES CertifiedJanuary 10, 2023

✔ NPI 1710691274 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in FL · 11023863

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

655 W 8TH ST, Jacksonville, FL 32209

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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

Jackie Floyd Hagenbaumer 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 ID749653962

PECOS Enrollment IDI20230308001928

Medicare Billing Reassignment

Medicare enrollment records show Jackie Hagenbaumer reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Florida Jacksonville Physicians Inc

Same address

Diagnostic Radiology

655 W 8TH ST, UFJP RADIOLOGY
Jacksonville, FL 32209

Reassigned Medicare billing, Florida enrollment
1,456 clinicians in this Medicare group

NPI 1326208695 (904) 244-3660

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

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

Shands Jacksonville

Acute Care Hospitals · Jacksonville, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100001

Location655 W 8th StJacksonville, FL 32209 · Duval County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32209 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

Most-billed visit code 99213

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 20

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

DR. MATTHEW DUWAIN WARRICK M.D.

Anesthesiology