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

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: October 25, 2026.

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

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 Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Jacqueline Stark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Amg Illinois Ltd
12 mi
Internal Medicine
45 TOWER CT, SUITE C
Gurnee, IL 60031
  • Reassigned Medicare billing, Illinois enrollment
  • 62 clinicians in this Medicare group
NPI 1972741759 (847) 623-3200
Aurora Medical Group, Inc.
32 mi
Nurse Anesthetist, Certified Registered
3301 W FOREST HOME AVE
Milwaukee, WI 53215
  • Reassigned Medicare billing, Wisconsin enrollment
  • 4,609 clinicians in this Medicare group
NPI 1427271378 (877) 576-3544

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 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.

MYA REESE DC
Chiropractor
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Kenosha County (262) 857-5300
MADELINE CLAIRE JERRY
Physical Therapist
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Kenosha County (262) 857-5800
WILLIAM J LYON PT
Physical Therapist
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Kenosha County (262) 857-5000
LAUREN M GEHRIG NP
Nurse Practitioner
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Kenosha County (262) 857-5000
MS. CATHLEEN DENISE FOSTER MS, OTR
Occupational Therapist
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Kenosha County (262) 857-5000
COLLEEN COURTNEY PA-C
Physician Assistant
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Kenosha County (262) 857-5400
STEPHANIE L FREDERICKSON PT, DPT
Physical Therapist
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Kenosha County (262) 857-5000
JEFFREY ALLEN GREENE PA
Physician Assistant
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Kenosha County (262) 857-5000

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 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.

Where is Jacqueline Stark located?

Jacqueline Stark practices at 12500 Aurora Dr, Pleasant Prairie, WI 53158. The listed phone number is (262) 857-5000.

What is Jacqueline Stark's specialty?

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

Is Jacqueline Stark enrolled in Medicare?

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

Which organizations bill Medicare for Jacqueline Stark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Stark reassigns Medicare benefits to 2 organizations: Amg Illinois Ltd (Gurnee, IL) and Aurora Medical Group, Inc. (Milwaukee, WI). 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 Jacqueline Stark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jacqueline Stark accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), Network Health and Quartz and 1 other insurer list Jacqueline Stark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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 2 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.