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Dr. Jessica Nicole Chacko , MD

Pediatrics β€’ Lithia, FL

Active NPI 1790273852 Individual Practitioner Female Practitioner
Practice location in NPPES

12649 Horseshoe Bend Dr
Lithia, FL 335473311

Call 7752337196 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

12649 Horseshoe Bend Dr

Lithia, FL 335473311

Telephone 7752337196
Other Listings in Public Data

NPPES lists 1 additional practice-address record in Sun City Center, FL. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Chacko has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Chacko as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Lithia and Florida

5 active clinicians are listed under Pediatrics with a practice address in Lithia, FL (4,001 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-08-21
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

License # reported to NPPES FL ME150652

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

ORDER AND REFERRING ONLY - PEDIATRIC MEDICINE

Medicare Enrollment ID

I20260608003000

Enrollment State Jurisdiction

FL

PECOS Control ID

9133690449

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

970 Cypress Village Blvd

Sun City Center, FL 335736830

Phone: 8133591561

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location July 26, 2024

Registered at 12649 HORSESHOE BEND DR, LITHIA, FL 335473311 (Tel: 7752337196)

πŸ“
Updated Business Mailing Address July 26, 2024

Registered at 12649 HORSESHOE BEND DR, LITHIA, FL 335473311 (Tel: 7752337196)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 26, 2024

Pediatrics (license number reported to NPPES: FL ME150652)

πŸ‘€
Provider Name / Credentials Updated January 15, 2021

Recorded as JESSICA CHACKO, MD

βœ…
NPI Profile Active April 24, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 24, 2018

Registered at 3100 SW 62ND AVE, MIAMI, FL 331553009 (Tel: 3056666511)

πŸ“
Business Mailing Address (Initial Record) April 24, 2018

Registered at 3100 SW 62ND AVE, MIAMI, FL 331553009 (Tel: 3056666511)

πŸ‘€
Provider Name / Credentials (Initial Record) April 24, 2018

Recorded as JESSICA WEIN, MD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 24, 2018

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration April 24, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1790273852
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 24, 2018
Last Update: August 21, 2024
Sole Proprietor: No

Mailing Address

12649 Horseshoe Bend Dr

Lithia, FL 335473311

Phone: 7752337196

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.