AGNES LIMUNGA JACKAI APRN, CNP, PMHNP-BC
NPI 1891403135
Nurse Practitioner - Psychiatric/Mental Health in Blaine, MN

Q: 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.

Q: 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.

Q: 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 14 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 November 07, 2022PECOS Enrolled

1521 93RD LN NE STE 100, BLAINE, MN 55449(612) 598-3937 Get Directions Write a Review

NPPES record last updated: May 14, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 14, 2025, Mar 22, 2023, Nov 7, 2022 (3 updates tracked since 2022).

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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, maintains a secondary practice location in Minneapolis, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1891403135

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameAGNES LIMUNGA JACKAICredential: APRN, CNP, PMHNP-BC

Location Address1521 93RD LN NE STE 100Blaine, MN 55449-4432

Mailing Address1521 93rd Ln Ne Ste 100Blaine, MN 55449-4432 · (612) 598-3937

Phone(612) 598-3937

Sole ProprietorYes

Medical School CMSOtherGraduated 2022

Enumeration DateNovember 7, 2022

Last NPPES UpdateMay 14, 20253 updates tracked since enumeration

NPPES CertifiedMay 14, 2025

✔ NPI 1891403135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in MN · 10001

1521 93RD LN NE STE 100, Blaine, MN 55449

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Secondary Practice Location 1

Location 11810 Hayes St NE Apt 12Minneapolis, MN 55418-5005 · Phone (612) 598-3937

Medicare Participation & PECOS CMS

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

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).

PECOS PAC ID4486013653

PECOS Enrollment IDI20231005003509

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 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.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

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 4

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

THE ANCHOR HEALTH AND SUPPOET SERVICES

Respite Care

1521 93RD LN NE STE 100
BLAINE, MN 55449

Anoka County (612) 964-8772

KINDRED COUNSELING PLLC

Marriage & Family Therapist

1521 93RD LN NE STE 100
BLAINE, MN 55449

Anoka County (612) 412-1384

MISS APRIL KAY WILLIAMSON LMFT

Marriage & Family Therapist

1521 93RD LN NE STE 100
BLAINE, MN 55449

Anoka County (612) 412-1384

PEACEOFMIND PSYCHIATRY & WELLNESS LLC

Clinic/Center (Mental Health (Including Community Mental Health Center))

1521 93RD LN NE STE 100
BLAINE, MN 55449

Anoka County (612) 598-3937

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.

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 14 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.