DR. JACQUELINE MARIA FENNERTY DPM
NPI 1992871495
Podiatrist in Springfield, OR

Q: What is Jacqueline Fennerty's NPI number?

The NPI number for Jacqueline Fennerty is 1992871495. It was assigned to this individual provider in the NPPES registry on November 27, 2006. The provider is also known as Dr. Jacqueline Maria Kordich Dpm.

Q: What is Jacqueline Fennerty's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Active since November 27, 2006PECOS EnrolledAccepts Medicare Assignment

1435 G ST, SPRINGFIELD, OR 97477(541) 735-9420 Get Directions Write a Review

NPPES record last updated: January 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 12, 2023, Mar 17, 2018, Nov 14, 2017 and 1 more (4 updates tracked since 2016).

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About Dr. Jacqueline Maria Fennerty Dpm NPPES

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

DR. JACQUELINE MARIA FENNERTY DPM (NPI 1992871495) is an individual podiatrist in Springfield, Oregon, licensed in Oregon (DP00292) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, maintains a secondary practice location in Elmira, and is a graduate of California School Of Podiatric Medicine (1996).

NPPES Registry Identity

NPI1992871495

Entity TypeIndividualFemale

Primary Taxonomy213E00000X

Provider Legal NameDR. JACQUELINE MARIA FENNERTYCredential: DPM

Location Address1435 G STSpringfield, OR 97477-4113

Mailing Address25121 Tripp RdElmira, OR 97437-9612 · (415) 219-3875 · Fax (541) 302-9481

Phone(541) 735-9420

Sole ProprietorYes

Medical School CMSCalifornia School Of Podiatric MedicineGraduated 1996

Enumeration DateNovember 27, 2006

Last NPPES UpdateJanuary 14, 20254 updates tracked since enumeration

NPPES CertifiedJanuary 14, 2025

✔ NPI 1992871495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers

Taxonomy Code213E00000X

License✔ Licensed in OR · DP00292

Definition

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

1435 G ST, Springfield, OR 97477

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Other Names 1

Professional Name (2)Dr. Jacqueline Maria Kordich Dpm

Secondary Practice Location 1

Location 125121 Tripp RdElmira, OR 97437-9612 · Phone (541) 521-9387 · Fax (541) 302-9481

Other Identifiers 1

Medicaid150584OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, PacificSource Health Plans, Regence BlueCross BlueShield of Oregon.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

Dr. Jacqueline Maria Fennerty Dpm 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 ID1254435076

PECOS Enrollment IDI20070403000383

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 97477 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

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.68 – $136.19

Typical copayment $17.16 (range $4.42 – $34.04)

Most-billed visit code 99213

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.

G STREET INTEGRATED HEALTH

Clinic/Center