Individual provider Active NPI

Jamie Nichole Restivo, PA-C

  • Physician Assistant
  • Enola, PA
National Provider Identifier
1013415264
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
CO6715 Issued in MD
Practice address
1822 Good Hope Rd
Enola, PA 17025-1233
Phone
(717) 763-7685
NPI assigned
Jan 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CO6715 MD Primary

Addresses

Primary practice location

1822 Good Hope Rd
Enola, PA 17025-1233

Mailing address

1822 Good Hope Rd
Enola, PA 17025-1233
Phone (717) 763-7685

Other practice location 1

414 Westside Blvd
Baltimore, MD 21228-4028
Phone (410) 591-4482

Other practice location 2

414 Westside Blvd
Baltimore, MD 21228-4028
Phone (410) 591-4482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180821000946 PA Practitioner - Physician Assistant 1557610896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crumay Parnes Associates, Inc.Group PAC ID 7719976604, 6 clinicians

Practice addresses (Care Compare)

1822 Good Hope Rd
Enola, PA 17025-1233
Phone (717) 763-7685

Hospital & facility affiliations

  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256

Merit-based Incentive Payment System (MIPS)

Final score
94.03 of 100Reported as group
Quality
88.06
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
CO6715MDMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1013415264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1822 GOOD HOPE RD",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251233",
            "telephone_number": "717-763-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 GOOD HOPE RD",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251233",
            "telephone_number": "717-763-7685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "414 Westside Blvd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212284028",
            "country_code": "US",
            "telephone_number": "410-591-4482",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "414 Westside Blvd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212284028",
            "country_code": "US",
            "telephone_number": "410-591-4482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RESTIVO",
        "first_name": "JAMIE",
        "middle_name": "NICHOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-23",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "CO6715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enola, PA

Sources for this page

Verify at the official NPI Registry.