Jacob Lawrence Pessia, MS IV

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

34.014475 Issued in OH

Practice address

100 Jackson Pike
Gallipolis, OH 45631-1560

Phone

(740) 441-1949

Fax

(740) 446-5982

NPI assigned

Apr 4, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH, WV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Merit-based Incentive Payment System (MIPS)

Final score

84.27 of 100Reported as group

Quality

68.56

Promoting interoperability

100

Improvement activities

40

Cost

68.7

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.pessia.1@17389.direct.athenahealth.com

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.

• Holzer Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Gallipolis, OH
  • NPI 1508817248

  WV

  Medicare reassignment NPD
• I Path LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Gallipolis, OH
  • NPI 1942525563
  NPD

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1093248478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HOLZER CLINIC, LLC",
            "address_2": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-441-1949",
            "fax_number": "740-446-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-441-1949",
            "fax_number": "740-446-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESSIA",
        "first_name": "JACOB",
        "middle_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "MS IV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-04",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34.014475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacob.pessia.1@17389.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "100 Jackson Pike",
            "city": "Gallipolis",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456311560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Payne, LPN
• Robert Pegg
• Esha J Pell, PSYCH TRAINEE
• Bruce L. Pennington, M.D.
• Carissa M Pessia, AUD
• Easton Petitt, PA-C
• Elizabeth Petrie, RPH
• Hayley Pettit, PHD
• Randy L Phillips
• Erich Philson

• Pediatrics Physician in Gallipolis, OH
• Providers in Gallipolis, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.