Ms Jacqueline A Stark, CPNP - Medicare Nurse Practitioner in Pleasant Prairie, WI

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Ms Jacqueline A Stark, CPNP is a medicare enrolled "Nurse Practitioner" in Pleasant Prairie, Wisconsin. Her current practice location is 12500 Aurora Dr, Pleasant Prairie, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (262) 857-5000.

Ms Jacqueline A Stark is licensed to practice in Wisconsin (license number 6437) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1811052319.

Contact Information

Ms Jacqueline A Stark, CPNP
12500 Aurora Dr,
Pleasant Prairie, WI 53158-1227
(262) 857-5000
(262) 857-5001

Map and Direction




Provider's Profile

Full NameMs Jacqueline A Stark
GenderFemale
SpecialityNurse Practitioner
Location12500 Aurora Dr, Pleasant Prairie, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1811052319
  • Provider Enumeration Date: 12/26/2006
  • Last Update Date: 08/28/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 1850512799
  • Enrollment ID: I20141018000008

Medical Identifiers

Medical identifiers for Ms Jacqueline A Stark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1811052319NPI-NPPES
100046653MedicaidWI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0200XNurse Practitioner - Pediatrics 6437 (Wisconsin)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 1999139490 (Missouri)Secondary
363L00000XNurse Practitioner 6437 (Wisconsin)Primary

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. Ms Jacqueline A Stark allows following entities to bill medicare on her behalf.
Entity NameAmg Illinois Ltd
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972741759
PECOS PAC ID: 8527117027
Enrollment ID: O20090512000348

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. Ms Jacqueline A Stark 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
Ms Jacqueline A Stark, CPNP
Po Box 735044,
Chicago, IL 60673-5044

Ph: (800) 326-2250		Ms Jacqueline A Stark, CPNP
12500 Aurora Dr,
Pleasant Prairie, WI 53158-1227

Ph: (262) 857-5000

Reviews and Comments


Nurse Practitioner Nurses in Pleasant Prairie, WI

Lauren M Gehrig, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 12500 Aurora Dr, Pleasant Prairie, WI 53158
Phone: 262-857-5000    
Laronda James, NURSE PRACTITIONER
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 9697 Saint Catherines Dr, Pleasant Prairie, WI 53158
Phone: 262-656-3338    Fax: 262-656-3368
Shannon L Yow,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 9555 76th St, Pleasant Prairie, WI 53158
Phone: 414-290-6720    Fax: 414-290-6755
Mankaa Vifansi,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 10505 Corporate Dr Ste 105g, Pleasant Prairie, WI 53158
Phone: 224-623-7883    
Mutsa Vollmer, APRN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 9555 76th St, Pleasant Prairie, WI 53158
Phone: 262-577-8000    
Jennifer Erich, APNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 10256 Old Green Bay Rd Fl 2, Pleasant Prairie, WI 53158
Phone: 262-551-4200    
Dr. Christina Marie Stallard, DNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 12500 Aurora Dr, Pleasant Prairie, WI 53158
Phone: 262-857-5400    

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.