Individual provider Active NPI

Jill N Orris, PA C

  • Surgical Physician Assistant
  • Erie, PA
National Provider Identifier
1083678288
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
OA000716 Issued in PA
Practice address
5401 Peach St Ste 3300
Erie, PA 16509-2601
Phone
(814) 868-7840
Fax
(814) 868-2139
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA050706 PA
Surgical Physician Assistant 363AS0400X OA000716 PA Primary

Addresses

Primary practice location

5401 Peach St Ste 3300
Erie, PA 16509-2601

Mailing address

1 Lecom PL
Erie, PA 16505-2571
Phone (814) 868-2529

Other identifiers 2

IdentifierTypeStateIssuer
P00238259OtherRAILROAD MEDICARE
1524835OtherPAHIGHMARK

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
I20040228000178 PA Practitioner - Physician Assistant 1456248111 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Erie CurrentSince Aug 1, 2023 Accepting new patients
Medical Associates of Erie CurrentSince Aug 1, 2023 Accepting new patients
Millcreek Community Hospital Current Accepting new patients
Fred Jamie W Holland II MD PC Past Accepting new patients
St Vincent Medical Education and Research Institute Inc Past Accepting new patients

Locations

1 Lecom Pl
Ste 3
Erie, PA 16505

2625 Parade St
Erie, PA 16504
Phone (814) 452-6383

5401 Peach St
Ste 3300
Erie, PA 16509
Phone (814) 868-7840

1 Lecom Pl
Erie, PA 16505

Organizations & group practices 6

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1083678288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LECOM PL",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052571",
            "telephone_number": "814-868-2529",
            "fax_number": "814-868-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 PEACH ST STE 3300",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092601",
            "telephone_number": "814-868-7840",
            "fax_number": "814-868-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORRIS",
        "first_name": "JILL",
        "middle_name": "N",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA050706",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "OA000716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00238259",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1524835",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.