Jacqueline Anderson, - Medicare Nurse Practitioner in Santa Rosa, CA

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Jacqueline Anderson, is a medicare enrolled "Nurse Practitioner - Family" in Santa Rosa, California. She went to Georgetown University School Of Medicine and graduated in 2014 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Providence Medical Foundation and her current practice location is 2057 Northfield Dr, Santa Rosa, California. You can reach out to her office (for appointments etc.) via phone at (707) 775-8510.

Jacqueline Anderson is licensed to practice in California (license number 95000793) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1205245255.

Contact Information

Jacqueline Anderson,
2057 Northfield Dr,
Santa Rosa, CA 95403-2073
(707) 775-8510
Not Available

Map and Direction




Provider's Profile

Full NameJacqueline Anderson
GenderFemale
SpecialityNurse Practitioner
Experience10 Years
Location2057 Northfield Dr, Santa Rosa, California
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jacqueline Anderson attended and graduated from Georgetown University School Of Medicine in 2014
  NPI Data:
  • NPI Number: 1205245255
  • Provider Enumeration Date: 08/04/2014
  • Last Update Date: 10/14/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 4981920956
  • Enrollment ID: I20150310001813

Medical Identifiers

Medical identifiers for Jacqueline Anderson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1205245255NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 95000793 (California)Secondary
363LF0000XNurse Practitioner - Family 95000793 (California)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
St. Joseph Home Care - Greater Sonoma CountySanta rosa, CAHome health agency
Santa Rosa Memorial HospitalSanta rosa, CAHospital
Healdsburg District HospitalHealdsburg, CAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Providence Medical Foundation89219932051312

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jacqueline Anderson allows following entities to bill medicare on her behalf.
Entity NameProvidence Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285890624
PECOS PAC ID: 8921993205
Enrollment ID: O20040216001346
Entity NameNorth Sonoma County Health Care District
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1194824573
PECOS PAC ID: 4789594367
Enrollment ID: O20060406000251

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacqueline Anderson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jacqueline Anderson,
2057 Northfield Dr,
Santa Rosa, CA 95403-2073

Ph: (707) 775-8510		Jacqueline Anderson,
2057 Northfield Dr,
Santa Rosa, CA 95403-2073

Ph: (707) 775-8510

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.