Individual provider Active NPI

Jessica KT Knauss, PA-C

  • Medical Physician Assistant
  • Whitehall, PA
National Provider Identifier
1265762850
Registry record updated Apr 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA054267 Issued in PA
Practice address
1401 Fairmont St
Whitehall, PA 18052-6015
Phone
(610) 432-4122
Fax
(612) 432-6677
NPI assigned
Jan 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA054267 PA Primary

Addresses

Primary practice location

1401 Fairmont St
Whitehall, PA 18052-6015

Mailing address

1401 Fairmont St
Whitehall, PA 18052-6015
Phone (610) 432-4122

Other names 1

  • Jessica K Teders Former name

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
I20110323000522 PA Practitioner - Physician Assistant 5092998443 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

3024 Easton Ave
LVPG Family Medicine
Bethlehem, PA 18017-4208
Phone (610) 694-1000

Hospital & facility affiliations

  • Bayada Home Health Care, Inc. Home health agency, Allentown, PA, CCN 397533
  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA054267PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Apr 18, 2011 Accepting new patients
Lehigh Valley Physician Group CurrentSince Apr 18, 2011 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1730 Chew St
Allentown, PA 18104
Phone (610) 402-3500

3024 Easton Ave
Bethlehem, PA 18017
Phone (610) 694-1000

2545 Schoenersville Rd
Bethlehem, PA 18017
Phone (484) 884-2888

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

1401 Fairmont St
Whitehall, PA 18052
Phone (610) 432-4122

Organizations & group practices 5

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 6

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": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396569600000",
    "number": "1265762850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 FAIRMONT ST",
            "city": "WHITEHALL",
            "state": "PA",
            "postal_code": "180526015",
            "telephone_number": "610-432-4122",
            "fax_number": "612-432-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 FAIRMONT ST",
            "city": "WHITEHALL",
            "state": "PA",
            "postal_code": "180526015",
            "telephone_number": "610-432-4122",
            "fax_number": "612-432-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNAUSS",
        "first_name": "JESSICA",
        "middle_name": "KT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-05",
        "last_updated": "2014-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "TEDERS",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Whitehall, PA

Sources for this page

Verify at the official NPI Registry.