Individual provider Active NPI

Sydney Jackson, PA-C

  • Physician Assistant
  • Torrance, CA
National Provider Identifier
1235708777
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1907 Border Ave
Torrance, CA 90501-3606
Phone
(844) 443-6246
NPI assigned
Jun 19, 2021
Last updated
Jan 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 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 Primary

Addresses

Primary practice location

1907 Border Ave
Torrance, CA 90501-3606

Mailing address

3072 Rockbridge Dr
Highlands Ranch, CO 80129-2237
Phone (303) 501-5075

Other practice location 1

35 W 35th St
New York, NY 10001-2205
Phone (303) 501-5075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, MI, CA, PA5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20230919000118 NY Practitioner - Physician Assistant 8628469798 Reassigns benefits to 2 organizations
I20231019000028 NJ Practitioner - Physician Assistant 8628469798 Reassigns benefits to 2 organizations
I20240529000124 MI Practitioner - Physician Assistant 8628469798 Reassigns benefits to 1 organization
I20240605003392 CA Practitioner - Physician Assistant 8628469798 Reassigns benefits to 1 organization
I20250813001993 PA Practitioner - Physician Assistant 8628469798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
New York College of Osteo Medicine of New York Institute of Technology, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10 Woodbridge Ctr Dr
Suite 425
Woodbridge, NJ 07095-1170

3089 SE Brierwood PL
Stuart, FL 34997-4718

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ambulnz Ny 2 LLC PastSince Jul 3, 2022 Accepting new patients
Ambulnz Ny LLC PastSince Jul 3, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sydney.jackson.1@24989.direct.athenahealth.com

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

NPI Registry JSON

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

{
    "created_epoch": "1624060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1235708777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3072 ROCKBRIDGE DR",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292237",
            "telephone_number": "303-501-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 BORDER AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905013606",
            "telephone_number": "844-443-6246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 W 35th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100012205",
            "country_code": "US",
            "telephone_number": "303-501-5075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SYDNEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-19",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.