JACLYN NOEL MARIE JEZAK CNP
NPI 1922764760
Nurse Practitioner - Psychiatric/Mental Health in Fremont, OH

Active since November 16, 2021PECOS EnrolledAccepts Medicare Assignment
710 CLEVELAND AVE, FREMONT, OH 43420(419) 334-6619 Get Directions Write a Review

NPPES record last updated: November 3, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 3, 2023, Nov 22, 2021, Nov 16, 2021 (3 updates tracked since 2021).

About Jaclyn Noel Marie Jezak Cnp NPPES

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

JACLYN NOEL MARIE JEZAK CNP (NPI 1922764760) is an individual psychiatric/mental health provider in Fremont, Ohio, licensed in Ohio (APRN.CNP.0030241) and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS, is affiliated with Promedica Toledo Hospital, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1922764760
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameJACLYN NOEL MARIE JEZAKCredential: CNP
Location Address710 CLEVELAND AVEFremont, OH 43420-3224
Mailing Address4300 Champlin DrPerrysburg, OH 43551-7178 · (419) 266-5297
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateNovember 16, 2021
Last NPPES UpdateNovember 3, 20233 updates tracked since enumeration
NPPES CertifiedNovember 22, 2021
NPI 1922764760 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 OH · APRN.CNP.0030241
710 CLEVELAND AVE, Fremont, OH 43420

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jaclyn Noel Marie Jezak Cnp 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 ID3072906643
PECOS Enrollment IDI20220202001870
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.

Areas of Expertise CMS Part B claims 2

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
67 services22 patients
Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
28 services13 patients

Hospital Affiliations CMS Care Compare

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

Promedica Toledo Hospital

Acute Care Hospitals · Toledo, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360068
Location2142 North Cove BoulevardToledo, OH 43606 · Lucas County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43420 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

Physical Therapist
710 CLEVELAND AVE
FREMONT, OH 43420
Nurse Practitioner (Psychiatric/Mental Health)
710 CLEVELAND AVE
FREMONT, OH 43420
Physical Therapist
710 CLEVELAND AVE
FREMONT, OH 43420
Nurse Practitioner (Psychiatric/Mental Health)
710 CLEVELAND AVE
FREMONT, OH 43420
Physical Therapist
710 CLEVELAND AVE
FREMONT, OH 43420
Physical Therapist
710 CLEVELAND AVE
FREMONT, OH 43420
Physical Therapist
710 CLEVELAND AVE
FREMONT, OH 43420
Physical Therapist
710 CLEVELAND AVE
FREMONT, OH 43420

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 Jaclyn Jezak's NPI number?

The NPI number for Jaclyn Jezak is 1922764760. It was assigned to this individual provider in the NPPES registry on November 16, 2021.

Where is Jaclyn Jezak located?

Jaclyn Jezak practices at 710 Cleveland Ave, Fremont, OH 43420. The listed phone number is (419) 334-6619.

What is Jaclyn Jezak's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Jaclyn Jezak enrolled in Medicare?

Yes. Jaclyn Jezak 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.

What insurance does Jaclyn Jezak accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Care Network of Michigan, CareSource, MedMutual and Oscar Health Insurance and 2 other insurers list Jaclyn Jezak 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 Jaclyn Jezak affiliated with any hospitals?

According to CMS data, Jaclyn Jezak is affiliated with Promedica Toledo Hospital.

When was this NPI record last updated?

The NPPES record for Jaclyn Jezak was last updated on November 3, 2023. 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.