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MRS. JACKLYN HAGG AGACNP
NPI 1861928111
Nurse Practitioner in Idaho Falls, ID

Active since May 05, 2017PECOS EnrolledAccepts Medicare Assignment
3100 CHANNING WAY, IDAHO FALLS, ID 83404(208) 529-6111(208) 529-7021 Get Directions Write a Review

NPPES record last updated: June 17, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mrs. Jacklyn Hagg Agacnp NPPES

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

MRS. JACKLYN HAGG AGACNP (NPI 1861928111) is an individual nurse practitioner in Idaho Falls, Idaho, licensed in Idaho (66593) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS, is affiliated with Eastern Idaho Regional Medical Center, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1861928111
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMRS. JACKLYN HAGGCredential: AGACNP
Location Address3100 CHANNING WAYIdaho Falls, ID 83404-7533
Mailing AddressPo Box 277381Atlanta, GA 30384-7381
Phone(208) 529-6111
Fax(208) 529-7021
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateMay 5, 2017
Last NPPES UpdateJune 17, 2021
NPPES CertifiedJune 17, 2021
✔ NPI 1861928111 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in ID · 66593
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 · Acute CareTaxonomy 363LA2100X · License AP 60730619 (WA)
3100 CHANNING WAY, Idaho Falls, ID 83404
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

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

Mrs. Jacklyn Hagg Agacnp 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 ID4183995202
PECOS Enrollment IDI20210923001103
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 Jacklyn Hagg reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Idaho Physician Services Inc.
0.1 mi
Orthopaedic Surgery
3200 CHANNING WAY STE A205
Idaho Falls, ID 83404
  • Reassigned Medicare billing, Idaho enrollment
  • 18 clinicians in this Medicare group
NPI 1902841893 (208) 535-4580
Intensive Care Consortium Inc
2,156 mi
Specialist
20900 BISCAYNE BLVD
Aventura, FL 33180
  • Reassigned Medicare billing, Idaho enrollment
  • 14 clinicians in this Medicare group
NPI 1629019062 (561) 997-0821

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

Areas of Expertise CMS Part B claims 5

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.
144 services95 patients
Critical care, each additional 30 minutes 99292
Critical care refers to special attention given to patients facing life-threatening conditions. Each additional 30 minutes indicates the extension of this specialized care. This might include close monitoring, medication adjustments, and immediate interventions as needed.
43 services27 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
27 services19 patients
Insertion of non-tunneled central venous tube for infusion (5 years or older) 36556
This procedure involves placing a thin tube into a large vein, usually in the neck or chest, to administer medication or fluids. It's done under local anesthesia to minimize discomfort. It's a standard, safe procedure for individuals aged 5 and above.
12 services12 patients
Ultrasonic guidance for blood vessel access 76937
Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Eastern Idaho Regional Medical Center

Acute Care Hospitals · Idaho Falls, ID
3/5 CMS rating
OwnershipProprietary
CMS Certification Number130018
Location3100 Channing WayIdaho Falls, ID 83404 · Bonneville County
Emergency services Birthing friendly

Lost Rivers Medical Center

Critical Access Hospitals · Arco, ID
OwnershipGovernment - Hospital District or Authority
CMS Certification Number131324
Location551 Highland DriveArco, ID 83213 · Butte County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83404 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
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
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.

CARL SAMUEL BRAYTON DO
Student in an Organized Health Care Education/Training Program
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (714) 616-4454
WALLACE LEONARD ARAVE PT
Physical Therapist
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 529-7999
REED D LOERTSCHER CRNA
Nurse Anesthetist, Certified Registered
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 529-6285
ALEXIS R SIDDOWAY NP
Nurse Practitioner (Neonatal)
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 535-4432
UNIVERSITY OF UTAH ADULT SERVICES
Internal Medicine (Nephrology)
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (801) 581-2121
MR. VENKATA KALYAN C BYRAPOGU MD
Student in an Organized Health Care Education/Training Program
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 970-1123
TAYLOR JAMES CARSON
Student in an Organized Health Care Education/Training Program
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 670-0407
NOOR ASHRAF NASSEF DO
Student in an Organized Health Care Education/Training Program
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 529-6111

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 Jacklyn Hagg's NPI number?

The NPI number for Jacklyn Hagg is 1861928111. It was assigned to this individual provider in the NPPES registry on May 5, 2017.

Where is Jacklyn Hagg located?

Jacklyn Hagg practices at 3100 Channing Way, Idaho Falls, ID 83404. The listed phone number is (208) 529-6111.

What is Jacklyn Hagg's specialty?

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

Is Jacklyn Hagg enrolled in Medicare?

Yes. Jacklyn Hagg is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jacklyn Hagg's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacklyn Hagg reassigns Medicare benefits to 2 organizations: Idaho Physician Services Inc. (Idaho Falls, ID) and Intensive Care Consortium Inc (Aventura, FL). 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 Jacklyn Hagg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jacklyn Hagg accept?

Health plans from Providence Health Plan list Jacklyn Hagg 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.

Is Jacklyn Hagg affiliated with any hospitals?

According to CMS data, Jacklyn Hagg is affiliated with Eastern Idaho Regional Medical Center and Lost Rivers Medical Center.

When was this NPI record last updated?

The NPPES record for Jacklyn Hagg was last updated on June 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.