Individual provider Active NPI

Jessica L Tisci, M.S., P.A.

  • Physician Assistant
  • Auburn, NY
National Provider Identifier
1225098635
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
010608-1 Issued in NY
Practice address
144 Standart Ave
Auburn, NY 13021-1508
Phone
(315) 255-1100
Fax
(315) 255-1322
NPI assigned
Mar 28, 2006
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 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 010608-1 NY Primary

Addresses

Primary practice location

144 Standart Ave
Auburn, NY 13021-1508

Mailing address

4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone (561) 948-0291

Other practice location 1

833 W Genesee Street Rd
Skaneateles, NY 13152-9303
Phone (315) 685-1100

Other practice location 2

7040 Manlius Center Rd
East Syracuse, NY 13057-9530
Phone (315) 671-2210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050617000806 NY Practitioner - Physician Assistant 7315981701 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Dermatology PLLCGroup PAC ID 5890131247, 7 clinicians

Practice addresses (Care Compare)

144 Standart Ave
Auburn, NY 13021-1508
Phone (315) 255-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
010608-1NYMDPhysical Therapist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1225098635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-948-0291",
            "fax_number": "561-859-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 STANDART AVE",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211508",
            "telephone_number": "315-255-1100",
            "fax_number": "315-255-1322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 W Genesee Street Rd",
            "address_purpose": "LOCATION",
            "city": "Skaneateles",
            "state": "NY",
            "postal_code": "131529303",
            "country_code": "US",
            "telephone_number": "315-685-1100",
            "fax_number": "315-685-2440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7040 Manlius Center Rd",
            "address_purpose": "LOCATION",
            "city": "East Syracuse",
            "state": "NY",
            "postal_code": "130579530",
            "country_code": "US",
            "telephone_number": "315-671-2210",
            "fax_number": "315-255-1322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TISCI",
        "first_name": "JESSICA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "M.S., P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010608-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.