Jami Alyssa Rubin Pavlak, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP025348 Issued in PA

Practice address

320 Rolling Ridge Dr Ste 100
State College, PA 16801-7641

Phone

(814) 867-0670

Fax

(814) 867-7616

NPI assigned

Jan 29, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jami Alyssa Rubin Former name

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Susquehanna Valley Professional Associates, IncGroup PAC ID 5395648745, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jami.pavlak@sunpointehealth.medentdirect.com

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.

• Susquehanna Valley Professional Associates, Inc

  • Psychiatry Physician
  • State College, PA
  • NPI 1578543054
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1265770010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 ROLLING RIDGE DR STE 100",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017641",
            "telephone_number": "814-867-0670",
            "fax_number": "814-867-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 ROLLING RIDGE DR STE 100",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017641",
            "telephone_number": "814-867-0670",
            "fax_number": "814-867-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLAK",
        "first_name": "JAMI",
        "middle_name": "ALYSSA RUBIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-29",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704294965",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP018828",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP025348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMI",
            "last_name": "RUBIN",
            "middle_name": "ALYSSA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shreya M Patel, MD
• Veeral B. Patel, MD
• Pathways to Change, Inc
• Benjamin R Paul, DPT
• Jessica Lynn Paul, DPT
• Connie Ann Peachey, LCSW
• Duane L. Peachey, P.T.
• Kiersten Elizabeth Pearce, PA-C
• Andrew James Pearson, DPT
• Kip M. Peeler, PA-C

• Psychiatric/Mental Health Nurse Practitioner in State College, PA
• Providers in State College, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.