Individual provider Active NPI

Sean Robert Jamieson, PA-C

  • Surgical Physician Assistant
  • Buffalo, NY
National Provider Identifier
1194342212
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA13702 Issued in TX
Practice address
Elm and Carlton St
Buffalo, NY 14263-0001
Phone
(716) 845-2300
NPI assigned
Jul 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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 025395 NY
Surgical Physician Assistant 363AS0400X PA13702 TX Primary

Addresses

Primary practice location

Elm and Carlton St
Buffalo, NY 14263-0001

Mailing address

2975 E Broad St Ste 200
Mansfield, TX 76063-9186
Phone (682) 518-8619

Other practice location 1

4560 Lake Ridge Pkwy Ste 300
Grand Prairie, TX 75052-1706
Phone (682) 518-8619

Other practice location 2

2975 E Broad St Ste 200
Mansfield, TX 76063-9186
Phone (682) 518-8619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NY2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20200727002440 TX Practitioner - Physician Assistant 7618391491 Reassigns benefits to 1 organization
I20230524001241 NY Practitioner - Physician Assistant 7618391491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roswell Park Cancer InstituteGroup PAC ID 3577475110, 487 clinicians

Practice addresses (Care Compare)

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025395NYMDMassage Therapist
PA13702TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Roswell Park Cancer Institute CurrentSince May 11, 2023 Accepting new patients
Roswell Park Cancer Institute CurrentSince May 11, 2023 Accepting new patients
Medhealth Current Accepting new patients
Medhealth CurrentSince Aug 1, 2020 Accepting new patients

Locations

Dept 8000
Buffalo, NY 14267

Elm and Carlton St
Buffalo, NY 14263

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

4560 Lake Ridge Pkwy
Ste 300
Grand Prairie, TX 75052
Phone (214) 278-5000

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

2700 E Broad St
Ste 200
Mansfield, TX 76063

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

2975 E Broad St
Ste 200
Mansfield, TX 76063
Phone (682) 518-8619

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.

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": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1194342212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2975 E BROAD ST STE 200",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639186",
            "telephone_number": "682-518-8619",
            "fax_number": "682-518-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4560 Lake Ridge Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Grand Prairie",
            "state": "TX",
            "postal_code": "750521706",
            "country_code": "US",
            "telephone_number": "682-518-8619",
            "fax_number": "682-518-8195",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2975 E Broad St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760639186",
            "country_code": "US",
            "telephone_number": "682-518-8619",
            "fax_number": "682-518-8195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMIESON",
        "first_name": "SEAN",
        "middle_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-06",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025395",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA13702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.