MS. JACQUELINE A STARK CPNP
NPI 1811052319
Nurse Practitioner in Pleasant Prairie, WI

Q: What is Jacqueline Stark's NPI number?

The NPI number for Jacqueline Stark is 1811052319. It was assigned to this individual provider in the NPPES registry on December 26, 2006.

Q: What is Jacqueline Stark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Jacqueline Stark was last updated on August 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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 December 26, 2006PECOS Enrolled

12500 AURORA DR, PLEASANT PRAIRIE, WI 53158(262) 857-5000(262) 857-5001 Get Directions Write a Review

NPPES record last updated: August 28, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 26, 2024, Nov 24, 2021, Jun 8, 2020 and 1 more (4 updates tracked since 2015).

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About Ms. Jacqueline A Stark Cpnp NPPES

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

MS. JACQUELINE A STARK CPNP (NPI 1811052319) is an individual nurse practitioner in Pleasant Prairie, Wisconsin, licensed in Wisconsin (6437) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Kenosha.

NPPES Registry Identity

NPI1811052319

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMS. JACQUELINE A STARKCredential: CPNP

Location Address12500 AURORA DRPleasant Prairie, WI 53158-1227

Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250

Phone(262) 857-5000

Fax(262) 857-5001

Sole ProprietorNo

Enumeration DateDecember 26, 2006

Last NPPES UpdateAugust 28, 20244 updates tracked since enumeration

NPPES CertifiedAugust 28, 2024

✔ NPI 1811052319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in WI · 6437

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X · License 6437 (WI)

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License 1999139490 (MO)

12500 AURORA DR, Pleasant Prairie, WI 53158

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Secondary Practice Location 1

Location 110400 75th StKenosha, WI 53142-7884 · Phone (262) 948-5600

Other Identifiers 1

Medicaid100046653WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, CareSource (Common Ground Healthcare), Quartz and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Jacqueline A Stark Cpnp 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 53158 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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 20

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

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