NPIMap

Individual provider Active NPI

Jeremy R Tipton, PA

  • Physician Assistant
  • Huntingdon, PA
National Provider Identifier
1063640324
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1225 Warm Springs Ave
Huntingdon, PA 16652-2350
Phone
(814) 643-8367
Fax
(814) 643-8369
NPI assigned
Jun 25, 2009
Last updated
Oct 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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 PA Primary

Addresses

Primary practice location

1225 Warm Springs Ave
Huntingdon, PA 16652-2350

Mailing address

1225 Warm Springs Ave
Huntingdon, PA 16652-2350
Phone (814) 643-8295

Other practice location 1

21 S Brown St
Lewistown, PA 17044-8126
Phone (717) 447-0340

Other practice location 2

7651 Lake Raystown Shopping Ctr
Huntingdon, PA 16652-8403
Phone (814) 643-8750

Other identifiers 1

IdentifierTypeStateIssuer
1029412830001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091022000431 PA Practitioner - Physician Assistant 9335286467 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J C Blair Memorial HospitalGroup PAC ID 2668378407, 98 clinicians

Practice addresses (Care Compare)

1225 Warm Springs Ave
Huntingdon, PA 16652-2350
Phone (814) 643-2290

239 Colonnade Blvd
State College, PA 16803-2668
Phone (814) 643-8105

7651 Lake Raystown Shopping Ctr
Huntingdon, PA 16652-8403
Phone (814) 643-8250

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Care Services of Pennsylvania, P.C. Physician Assistant CurrentSince Apr 1, 2010 Accepting new patients
J C Blair Memorial Hospital Physician Assistant CurrentSince Oct 29, 2018 Accepting new patients
J C Blair Memorial Hospital CurrentSince Oct 29, 2018 Accepting new patients
Primary Health Network Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
J. C. Blair Memorial Hospital Past Accepting new patients

Locations

1225 Warm Springs Ave
Huntingdon, PA 16652
Phone (814) 643-8206

7651 Lake Raystown Shopping Ctr
Huntingdon, PA 16652
Phone (814) 643-8485

Interoperability endpoints

  • Direct secure messaging: jtipton@1285.direct.myezyaccess.com

Organizations & group practices 9

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

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1063640324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 WARM SPRINGS AVE",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166522350",
            "telephone_number": "814-643-8295",
            "fax_number": "814-643-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WARM SPRINGS AVE",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166522350",
            "telephone_number": "814-643-8367",
            "fax_number": "814-643-8369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 S Brown St",
            "address_purpose": "LOCATION",
            "city": "Lewistown",
            "state": "PA",
            "postal_code": "170448126",
            "country_code": "US",
            "telephone_number": "717-447-0340",
            "fax_number": "717-447-0344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7651 Lake Raystown Shopping Ctr",
            "address_purpose": "LOCATION",
            "city": "Huntingdon",
            "state": "PA",
            "postal_code": "166528403",
            "country_code": "US",
            "telephone_number": "814-643-8750",
            "fax_number": "814-643-8360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIPTON",
        "first_name": "JEREMY",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029412830001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon, PA

Sources for this page

Verify at the official NPI Registry.