Individual provider Active NPI

Jason Thomas Crump, PAC

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1104803170
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1791 Issued in ME
Practice address
8517 Chapin Street
Norfolk, VA 23503-4008
Phone
(540) 915-7195
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5102 CT
Physician Assistant 363A00000X PA1791 ME Primary
Physician Assistant 363A00000X PA9410 MA
Physician Assistant 363A00000X 0110002195 VA
Physician Assistant 363A00000X 2338 WV
Physician Assistant 363A00000X 021257 NY
Physician Assistant 363A00000X PA01297 RI

Addresses

Primary practice location

8517 Chapin Street
Norfolk, VA 23503-4008

Mailing address

8517 Chapin St
Norfolk, VA 23503-5501
Phone (540) 915-7195

Other practice location 1

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-5000

Other practice location 2

115 Lincoln St
Framingham, MA 01702-6358
Phone (508) 383-1000

Other practice location 3

100 Kenyon Ave
Wakefield, RI 02879-4216
Phone (401) 782-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NY, DE, OH, WV, RI, CT, MA, ME9 enrollments
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 9

Enrollment IDStateProvider typePAC IDDetails
I20051122000578 VA Practitioner - Physician Assistant 1658390448 Reassigns benefits to 1 organization
I20171010000733 NY Practitioner - Physician Assistant 1658390448 Reassigns benefits to 6 organizations
I20171103000901 DE Practitioner - Physician Assistant 1658390448 Reassigns benefits to 2 organizations
I20180314002334 OH Practitioner - Physician Assistant 1658390448 Reassigns benefits to 1 organization
I20200408003867 WV Practitioner - Physician Assistant 1658390448 Reassigns benefits to 1 organization
I20201228000346 RI Practitioner - Physician Assistant 1658390448 Reassigns benefits to 1 organization
I20210913001622 CT Practitioner - Physician Assistant 1658390448 Reassigns benefits to 2 organizations
I20230613001576 MA Practitioner - Physician Assistant 1658390448 Reassigns benefits to 1 organization
I20240603000862 ME Practitioner - Physician Assistant 1658390448 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021257NYMDPsychologist
5102CTMDPediatric Occupational Therapist
PA9410MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Healthcare CurrentSince Jul 1, 2019 Accepting new patients
Atlantic Physician Services of Maryland, PC Physician Assistant CurrentSince Sep 1, 2021 Accepting new patients
St Marys Healthcare CurrentSince Jul 1, 2019 Accepting new patients

Locations

307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300

380 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 841-7415

4950 State Highway 30
Amsterdam, NY 12010
Phone (518) 770-7557

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

Interoperability endpoints

  • Direct secure messaging: jcrump3196394@direct.trinity-health.org

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1104803170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8517 CHAPIN ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235035501",
            "telephone_number": "540-915-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8517 CHAPIN STREET",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235034008",
            "telephone_number": "540-915-7195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Summer St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016081216",
            "country_code": "US",
            "telephone_number": "508-363-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Framingham",
            "state": "MA",
            "postal_code": "017026358",
            "country_code": "US",
            "telephone_number": "508-383-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Kenyon Ave",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028794216",
            "country_code": "US",
            "telephone_number": "401-782-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUMP",
        "first_name": "JASON",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "5102",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1791",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9410",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002195",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "2338",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021257",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01297",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.