Mrs Jacquelyn Rene Forssberg, APRN - Medicare Nurse Practitioner in Great Bend, KS

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Mrs Jacquelyn Rene Forssberg, APRN is a medicare enrolled "Nurse Practitioner - Pediatrics" in Great Bend, Kansas. She graduated from nursing school in 2014 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Pratt Regional Medical Center Corporation and her current practice location is 1021 Eisenhower Ave, Great Bend, Kansas. You can reach out to her office (for appointments etc.) via phone at (620) 792-5437.

Mrs Jacquelyn Rene Forssberg is licensed to practice in Kansas (license number 53-76350-092) 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 1043628233.

Contact Information

Mrs Jacquelyn Rene Forssberg, APRN
1021 Eisenhower Ave,
Great Bend, KS 67530
(620) 792-5437
Not Available

Map and Direction




Provider's Profile

Full NameMrs Jacquelyn Rene Forssberg
GenderFemale
SpecialityNurse Practitioner
Experience10 Years
Location1021 Eisenhower Ave, Great Bend, Kansas
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:
  • Mrs Jacquelyn Rene Forssberg graduated from nursing school in 2014
  NPI Data:
  • NPI Number: 1043628233
  • Provider Enumeration Date: 07/31/2014
  • Last Update Date: 03/26/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 2264721539
  • Enrollment ID: I20160510002483

Medical Identifiers

Medical identifiers for Mrs Jacquelyn Rene Forssberg such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043628233NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0200XNurse Practitioner - Pediatrics 53-76350-092 (Kansas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Pratt Regional Medical CenterPratt, KSHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Pratt Regional Medical Center Corporation135525323834

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. Mrs Jacquelyn Rene Forssberg allows following entities to bill medicare on her behalf.
Entity NamePratt Regional Medical Center Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578596904
PECOS PAC ID: 1355253238
Enrollment ID: O20040419001344
Entity NameSt. Catherine Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659360196
PECOS PAC ID: 4789595844
Enrollment ID: O20050302000707
Entity NameSt Rose Health Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1619372000
PECOS PAC ID: 0042534224
Enrollment ID: O20150116000615

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. Mrs Jacquelyn Rene Forssberg 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
Mrs Jacquelyn Rene Forssberg, APRN
200 Commodore St,
Pratt, KS 67124-2903

Ph: (620) 450-1186		Mrs Jacquelyn Rene Forssberg, APRN
1021 Eisenhower Ave,
Great Bend, KS 67530

Ph: (620) 792-5437

Reviews and Comments


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Amanda Gail Lakin, APRN, PMHNP-BC
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Peter Mick, NP-C
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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.