Individual provider Active NPI

Jaclyn Marie Bissell, PA-C

  • Physician Assistant
  • Greensboro, NC
National Provider Identifier
1184875171
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04181 Issued in NC
Practice address
3200 Northline Avenue
Ste 200
Greensboro, NC 27408-7602
Phone
(336) 545-5000
Fax
(336) 545-5020
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-04181 NC Primary

Addresses

Primary practice location

3200 Northline Avenue
Ste 200
Greensboro, NC 27408-7602

Mailing address

3200 Northline Avenue
Ste 200
Greensboro, NC 27408-7602
Phone (336) 545-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20131127000414 NC Practitioner - Physician Assistant 5395804546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

799 Doctors CT
Roxboro, NC 27573-4571
Phone (336) 599-4079

Hospital & facility affiliations

  • Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

Merit-based Incentive Payment System (MIPS)

Final score
89.07 of 100Reported as group
Quality
85.94
Promoting interoperability
100
Improvement activities
40
Cost
77.63

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA CurrentSince Jan 1, 2019 Accepting new patients
Emergeortho PA Physician Assistant CurrentSince Jan 1, 2019 Accepting new patients

Locations

3200 Northline Ave
Ste 200
Greensboro, NC 27408
Phone (336) 544-3905

3200 Northline Ave
Ste 160
Greensboro, NC 27408
Phone (336) 545-3530

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

Interoperability endpoints

  • Direct secure messaging: jaclynbissell@go.allscriptsdirect.net

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1184875171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 NORTHLINE AVENUE",
            "address_2": "STE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087602",
            "telephone_number": "336-545-5000",
            "fax_number": "336-545-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 NORTHLINE AVENUE",
            "address_2": "STE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087602",
            "telephone_number": "336-545-5000",
            "fax_number": "336-545-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSELL",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.