Individual provider Active NPI

Jessica L Root, PA-C

  • Medical Physician Assistant
  • Wormleysburg, PA
National Provider Identifier
1063776359
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA055588 Issued in PA
Practice address
1000 N Front St
Wormleysburg, PA 17043-1034
Phone
(717) 731-0101
Fax
(717) 441-0592
NPI assigned
Jul 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA055588 PA Primary

Addresses

Primary practice location

1000 N Front St
Wormleysburg, PA 17043-1034

Mailing address

1000 N Front St
Wormleysburg, PA 17043-1021

Other identifiers 1

IdentifierTypeStateIssuer
103476590MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jroot46874@phsdirect.pinnaclehealth.org

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
I20120731000023 PA Practitioner - Physician Assistant 4183880560 Reassigns benefits to 2 organizations

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
Pinnacle Health Cardiovascular Institute IncGroup PAC ID 6901087006, 117 clinicians

Practice addresses (Care Compare)

2808 Old Post Rd
Harrisburg, PA 17110-3685
Phone (717) 920-4400

360 Alexander Spring Rd
Carlisle, PA 17015-9129
Phone (717) 243-6557

Merit-based Incentive Payment System (MIPS)

Final score
82.6 of 100Reported as group
Quality
70.07
Promoting interoperability
100
Improvement activities
40
Cost
71.93

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Dec 19, 2022 Accepting new patients
Pinnacle Health Medical Services CurrentSince Dec 19, 2022 Accepting new patients

Locations

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

2808 Old Post Rd
Harrisburg, PA 17110
Phone (717) 591-7122

1000 N Front St
Wormleysburg, PA 17043

Interoperability endpoints

  • Direct secure messaging: jroot301520@upmc.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1063776359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N FRONT ST",
            "city": "WORMLEYSBURG",
            "state": "PA",
            "postal_code": "170431021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N FRONT ST",
            "city": "WORMLEYSBURG",
            "state": "PA",
            "postal_code": "170431034",
            "telephone_number": "717-731-0101",
            "fax_number": "717-441-0592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "JESSICA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA055588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103476590",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jroot46874@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "1000 N Front St",
            "city": "Wormleysburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170431034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wormleysburg, PA

Sources for this page

Verify at the official NPI Registry.