AGNES LIMUNGA JACKAI APRN, CNP, PMHNP-BC
NPI 1891403135
Nurse Practitioner - Psychiatric/Mental Health in Blaine, MN
About Agnes Limunga Jackai Aprn, Cnp, Pmhnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AGNES LIMUNGA JACKAI APRN, CNP, PMHNP-BC (NPI 1891403135) is an individual psychiatric/mental health provider in Blaine, Minnesota, licensed in Minnesota (10001) and active in the NPI registry since November 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Minneapolis.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Agnes Limunga Jackai Aprn, Cnp, Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Agnes Jackai reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Blaine, MN 55449
- Reassigned Medicare billing, Minnesota enrollment
Durham, NC 27701
- Reassigned Medicare billing, Minnesota enrollment
- 98 clinicians in this Medicare group
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 55449 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BLAINE, MN 55449
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 Agnes Jackai's NPI number?
The NPI number for Agnes Jackai is 1891403135. It was assigned to this individual provider in the NPPES registry on November 7, 2022.
Where is Agnes Jackai located?
Agnes Jackai practices at 1521 93rd Ln NE Ste 100, Blaine, MN 55449. The listed phone number is (612) 598-3937.
What is Agnes Jackai's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Agnes Jackai enrolled in Medicare?
Yes. Agnes Jackai is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Agnes Jackai's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Agnes Jackai reassigns Medicare benefits to 2 organizations: Peaceofmind Psychiatry & Wellness LLC (Blaine, MN) and Mental Health Specialty Group PA (Durham, NC). 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 Agnes Jackai's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Agnes Jackai was last updated on May 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Agnes Limunga Jackai, APRN, CNP, PMHNP-BC · NPI 1891403135
Psychiatric/Mental Health physician in Blaine, Minnesota. Individual provider, active in the CMS NPPES registry since November 7, 2022.
## Identity
- **NPI:** 1891403135 (Entity type: Individual)
- **Enumerated:** November 7, 2022
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 10001 (Minnesota)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1521 93RD LN NE STE 100, Blaine, MN 55449-4432
- **Phone:** (612) 598-3937
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Peaceofmind Psychiatry & Wellness LLC (NPI 1891586582, Blaine, MN); Mental Health Specialty Group PA (NPI 1801472634, Durham, NC) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 14, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1891403135) · Data from the CMS NPPES public registry.