Individual provider Active NPI

Jeremy Tock, PA-C

  • Physician Assistant
  • York, PA
National Provider Identifier
1164068904
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA061092 Issued in PA
Practice address
1701 Innovation Dr
York, PA 17408-8815
Phone
(717) 988-0000
Fax
(717) 782-5716
NPI assigned
Nov 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA005082 PA
Physician Assistant 363A00000X MA061092 PA Primary

Addresses

Primary practice location

1701 Innovation Dr
York, PA 17408-8815

Mailing address

1701 Innovation Dr
York, PA 17408-8815
Phone (717) 988-0000

Other practice location 1

700 High St
Williamsport, PA 17701-3100
Phone (570) 321-2125

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address upmchospitals@upmcdirect.com Health Information Exchange (HIE)

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
I20191230000144 PA Practitioner - Physician Assistant 1456785450 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Emergency Department Services, LLCGroup PAC ID 0143124701, 106 clinicians

Practice addresses (Care Compare)

1701 Innovation Dr
York, PA 17408-8815
Phone (717) 988-0000

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
62.07
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OA005082PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Emergency Department Services LLC Physician Assistant CurrentSince Feb 1, 2026 Accepting new patients
Susquehanna Physician Services Physician Assistant CurrentSince Dec 1, 2019 Accepting new patients
Susquehanna Physician Services CurrentSince Dec 1, 2019 Accepting new patients

Locations

24 Cree Dr
Lock Haven, PA 17745
Phone (570) 893-5000

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

1701 Innovation Dr
York, PA 17408
Phone (717) 843-8623

Interoperability endpoints

  • Direct secure messaging: jtock252124@upmc.direct-ci.com

Organizations & group practices 4

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": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1164068904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 INNOVATION DR",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174088815",
            "telephone_number": "717-988-0000",
            "fax_number": "717-782-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 INNOVATION DR",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174088815",
            "telephone_number": "717-988-0000",
            "fax_number": "717-782-5716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 High St",
            "address_purpose": "LOCATION",
            "city": "Williamsport",
            "state": "PA",
            "postal_code": "177013100",
            "country_code": "US",
            "telephone_number": "570-321-2125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOCK",
        "first_name": "JEREMY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-26",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA005082",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "N",
            "endpointDescription": "secure UPMC direct address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "600 Grant St Fl 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.