Individual provider Active NPI

Jacqueline Renee Labelle, R-PAC

  • Physician Assistant
  • Williamsville, NY
National Provider Identifier
1033450143
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
016455-1 Issued in NY
Practice address
18 Limestone Dr
Williamsville, NY 14221-8602
Phone
(716) 632-1400
Fax
(716) 632-5316
NPI assigned
Mar 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2014

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 016455-1 NY Primary

Addresses

Primary practice location

18 Limestone Dr
Williamsville, NY 14221-8602

Mailing address

18 Limestone Dr
Williamsville, NY 14221-8602
Phone (716) 632-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140731001614 NY Practitioner - Physician Assistant 1557587342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

18 Limestone Dr
Suite 5
Williamsville, NY 14221-8602
Phone (716) 632-1400

3898 Vineyard Dr
Dunkirk, NY 14048-3559
Phone (716) 710-8266

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016455-1NYMDSpecialist

Interoperability endpoints

  • Direct secure messaging: jlabelle@gppc.medentdirect.com

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 6

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": "1363219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1033450143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 LIMESTONE DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218602",
            "telephone_number": "716-632-1400",
            "fax_number": "716-632-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 LIMESTONE DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218602",
            "telephone_number": "716-632-1400",
            "fax_number": "716-632-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABELLE",
        "first_name": "JACQUELINE",
        "middle_name": "RENEE",
        "credential": "R-PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-14",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016455-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.