Individual provider Active NPI

Jessica Igbokwe

  • Physician Assistant
  • Bowie, MD
National Provider Identifier
1275347957
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11002 Lake Deborah CT
Bowie, MD 20720-4273
Phone
(240) 601-9601
NPI assigned
Feb 4, 2025
Last updated
Feb 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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 NU Primary

Addresses

Primary practice location

11002 Lake Deborah CT
Bowie, MD 20720-4273

Mailing address

11002 Lake Deborah CT
Bowie, MD 20720-4273
Phone (240) 601-9601

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
I20251016000092 NY Practitioner - Physician Assistant 0749777449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1275 Broadway
Menands, NY 12204-2638

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince Sep 17, 2025 Accepting new patients
Albany Medical College CurrentSince Sep 17, 2025 Accepting new patients
Albany Medical College Physician Assistant Past Accepting new patients

Locations

43 New Scotland Ave
#139
Albany, NY 12208
Phone (518) 262-3131

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

Organizations & group practices 3

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": "1738627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1275347957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11002 LAKE DEBORAH CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204273",
            "telephone_number": "240-601-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11002 LAKE DEBORAH CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204273",
            "telephone_number": "240-601-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGBOKWE",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.