Individual ProviderJackylin CaparasInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address3909 New Vision Dr, Fort Wayne, IN 46845(260) 469-6602PECOS EnrollmentBased on the most recent information from CMS, provider Jackylin Caparas is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1881991834Provider TypeIndividualFull NameCaparas, JackylinCredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date2/26/2011Last Updated10/20/2022Contact InformationPractice LocationPractice Address3909 New Vision Dr, Fort Wayne, IN 46845Phone(260) 469-6602Fax(260) 969-3065Mailing LocationMailing Address11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense01070707AIndianaCode208M00000XDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicense01070707AIndianaProvider IdentifiersIDDescriptionIssuerIDANTHEMDescriptionOtherIssuer000000762410IndianaIDP01074066DescriptionOtherIssuerR.R. MEDICAREIndianaID201057340DescriptionMedicaidIssuerUnlistedIndiana