Individual provider Active NPI

Jawairia Islam, PA-C

  • Physician Assistant
  • Harrisburg, PA
National Provider Identifier
1215706130
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA065303 Issued in PA
Practice address
4230 Crums Mill Rd
Harrisburg, PA 17112-2898
Phone
(717) 233-6171
Fax
(717) 233-7880
NPI assigned
Dec 20, 2023
Last updated
Feb 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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 MA065303 PA Primary

Addresses

Primary practice location

4230 Crums Mill Rd
Harrisburg, PA 17112-2898

Mailing address

4230 Crums Mill Rd
Harrisburg, PA 17112-2898
Phone (717) 233-6171

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
I20240227001143 PA Practitioner - Physician Assistant 8325483647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1120 Cocoa Ave
Hershey, PA 17033-1712
Phone (717) 533-4141

4230 Crums Mill Rd
Suite 100
Harrisburg, PA 17112-2898
Phone (717) 233-6171

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA065303PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services Physician Assistant CurrentSince Feb 1, 2024 Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Mar 1, 2025 Accepting new patients
Pinnacle Health Medical Services CurrentSince Feb 1, 2024 Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Mar 1, 2025 Accepting new patients
Penn State Health Medical Group, LLC Past Accepting new patients

Locations

205 S Front St
Fl 6
Harrisburg, PA 17104
Phone (717) 231-8343

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

4230 Crums Mill Rd
Ste 100
Harrisburg, PA 17112
Phone (717) 233-6171

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1703030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1215706130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 CRUMS MILL RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171122898",
            "telephone_number": "717-233-6171",
            "fax_number": "717-233-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 CRUMS MILL RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171122898",
            "telephone_number": "717-233-6171",
            "fax_number": "717-233-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "JAWAIRIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-20",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA065303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.