Individual provider Active NPI

Jessica Kathryn Lockwood, RPA-C

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1073792891
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012210 Issued in NY
Practice address
1000 E Genesee St
Suite 500
Syracuse, NY 13210-1892
Phone
(315) 471-8388
Fax
(315) 471-8019
NPI assigned
Oct 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 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 012210 NY Primary

Addresses

Primary practice location

1000 E Genesee St
Suite 500
Syracuse, NY 13210-1892

Mailing address

1000 E Genesee St
Suite 500
Syracuse, NY 13210-1892
Phone (315) 471-8388

Other names 1

  • Miss Jessica Kathryn Martin Former name

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
I20080108000501 NY Practitioner - Physician Assistant 4981784501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5000 Campuswood Dr
Suite 200
East Syracuse, NY 13057-1268
Phone (315) 234-6677

5415 W Genesee St
Suite 203
Camillus, NY 13031-2162
Phone (315) 324-6677

739 Irving Ave
Suite 430
Syracuse, NY 13210-1653
Phone (315) 234-6677

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.09 of 100Reported as group
Quality
97.07
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012210NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Gastroenterological Associates PC CurrentSince Dec 7, 2021 Accepting new patients
Endocrinology, Diabetes & Metabolism, PLLC Past Accepting new patients

Locations

739 Irving Ave
Ste 420
Syracuse, NY 13210
Phone (315) 470-7921

739 Irving Ave
Ste 430
Syracuse, NY 13210

Organizations & group practices 3

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 3

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": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395360000000",
    "number": "1073792891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E GENESEE ST",
            "address_2": "SUITE 500",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101892",
            "telephone_number": "315-471-8388",
            "fax_number": "315-471-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E GENESEE ST",
            "address_2": "SUITE 500",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101892",
            "telephone_number": "315-471-8388",
            "fax_number": "315-471-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKWOOD",
        "first_name": "JESSICA",
        "middle_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-29",
        "last_updated": "2014-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MARTIN",
            "middle_name": "KATHRYN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.