NPIMap

Individual provider Active NPI

Katie Jackley, PA-C

  • Surgical Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1184680167
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA051828 Issued in PA
Practice address
320 E North Ave Ste 208
Pittsburgh, PA 15212-4756
Phone
(412) 359-6200
Fax
(412) 359-6617
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051828 PA
Physician Assistant 363A00000X PA18658 CA
Medical Physician Assistant 363AM0700X PA18658 CA
Surgical Physician Assistant 363AS0400X PA18658 CA
Surgical Physician Assistant 363AS0400X MA051828 PA Primary

Addresses

Primary practice location

320 E North Ave Ste 208
Pittsburgh, PA 15212-4756

Mailing address

320 E North Ave Ste 208
Pittsburgh, PA 15212-4756
Phone (412) 359-6200

Other identifiers 1

IdentifierTypeStateIssuer
11680171OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041123000335 PA Practitioner - Physician Assistant 8325003908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allegheny ClinicGroup PAC ID 5395649586, 2,313 clinicians

Practice addresses (Care Compare)

1001 9TH Ave
Brackenridge, PA 15014-1107
Phone (412) 359-8850

12311 Perry Hwy
Wexford, PA 15090-8344
Phone (412) 359-3457

12351 Perry Hwy
Wexford, PA 15090-8344
Phone (412) 359-6581

200 Quinn Dr
Pittsburgh, PA 15275-1055

320 E N Ave
Pittsburgh, PA 15212-4756

647 N Broad St Ext
Grove City, PA 16127-4604

701 Broad St
Suite 431
Sewickley, PA 15143-1652
Phone (412) 741-0966

720 Blackburn Rd
FL 4
Sewickley, PA 15143-1459
Phone (412) 359-6200

Hospital & facility affiliations

  • Heritage Valley Sewickley Hospital, Sewickley, PA, CCN 390037
  • Ahn Wexford Hospital Hospital, Wexford, PA, CCN 390334
  • Grove City Medical Center Hospital, Grove City, PA, CCN 390266
  • Allegheny General Hospital Hospital, Pittsburgh, PA, CCN 390050
  • Jefferson Hospital Hospital, Jefferson Hills, PA, CCN 390265

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA18658CAMDSurgical Physician Assistant
MA051828PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic CurrentSince Jun 2, 2021 Accepting new patients
Allegheny Clinic CurrentSince Jun 2, 2021 Accepting new patients
Allegheny Clinic Past Accepting new patients
Allegheny Clinic Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1001 9th Ave
Brackenridge, PA 15014

320 E North Ave
Pittsburgh, PA 15212
Phone (412) 359-3131

320 E North Ave
Ste 208
Pittsburgh, PA 15212

701 Broad St
Ste 431
Sewickley, PA 15143
Phone (412) 741-0966

Interoperability endpoints

  • Direct secure messaging: kjackley371330@direct.ahn.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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1184680167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE STE 208",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-6200",
            "fax_number": "412-359-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE STE 208",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-6200",
            "fax_number": "412-359-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKLEY",
        "first_name": "KATIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051828",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18658",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA18658",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA18658",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA051828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11680171",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.