Jacquelyn N. Wilson, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0110003305 Issued in VA

Practice address

2800 Ivy Rd
Charlottesville, VA 22903

Phone

(434) 243-3600

Fax

(434) 244-4454

NPI assigned

Jun 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jacquelyn N Sedlock Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Virginia Physicians GroupGroup PAC ID 4880590728, 1,685 clinicians

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009

Merit-based Incentive Payment System (MIPS)

Final score

86.45 of 100Reported as group

Quality

79.76

Promoting interoperability

100

Improvement activities

40

Cost

75.07

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Rector & Visitors of the University of Virginia

  dba UVA Health Sciences Center

  • General Acute Care Hospital
  • Charlottesville, VA
  • NPI 1780630608
  Care Compare affiliation

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1114247426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 IVY RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22903",
            "telephone_number": "434-243-3600",
            "fax_number": "434-244-4454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-0211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JACQUELYN",
        "middle_name": "N.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-09",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003305",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110003305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114247426",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsedlock9812@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "545 Ray C Hunt Dr",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229032981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "SEDLOCK",
            "middle_name": "N",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caleb Joseph Wilson, M.A., CCC-SLP
• Carolyn S. Wilson, M.D.
• Chad B Wilson, P.A.
• Christi Wilson
• Corrie Wilson
• Jeffrey Michael Wilson
• Karie A. Wilson, ACNP
• Katherine Wilson, PSYD
• Kyle Alan Wilson, PA
• Monique D Wilson, PHD

• Surgical Physician Assistant in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Surgical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.