Individual provider Active NPI

Jaclyn Sharkazy, PA

  • Medical Physician Assistant
  • Allentown, PA
National Provider Identifier
1093230393
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA059149 Issued in PA
Practice address
1240 S Cedar Crest Blvd Ste 308
Allentown, PA 18103-6370
Phone
(610) 402-1350
Fax
(610) 402-1356
NPI assigned
Aug 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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 MA059149 PA Primary

Addresses

Primary practice location

1240 S Cedar Crest Blvd Ste 308
Allentown, PA 18103-6370

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622

Other names 1

  • Jaclyn Saliba Former name

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
I20170918003127 PA Practitioner - Physician Assistant 0244504074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

2649 Schoenersville Rd
Suite 100
Bethlehem, PA 18017-7326
Phone (484) 884-8110

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA059149PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Aug 14, 2017 Accepting new patients
Lehigh Valley Physician Group CurrentSince Aug 14, 2017 Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1240 S Cedar Crest Blvd
Ste 308
Allentown, PA 18103
Phone (610) 402-1175

2100 Mack Blvd
Fl 4
Allentown, PA 18103

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

2226 Blakeslee Boulevard Dr E
#200
Lehighton, PA 18235
Phone (484) 884-1007

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

600 Commerce Blvd
Stroudsburg, PA 18360
Phone (570) 424-7390

1411 Jacobsburg Rd
#2
Wind Gap, PA 18091

Interoperability endpoints

  • Direct secure messaging: jsaliba165092@direct2.lvhn.org

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.

Hospital & facility affiliations 5

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": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1093230393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 S CEDAR CREST BLVD STE 308",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036370",
            "telephone_number": "610-402-1350",
            "fax_number": "610-402-1356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARKAZY",
        "first_name": "JACLYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA059149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "SALIBA",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.