Jaclyn Marie Siverts, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

7674 Issued in AZ

Practice address

1675 E Melrose St Ste 101-103
Gilbert, AZ 85297-1001

Phone

(602) 648-5444

Fax

(602) 772-3801

NPI assigned

Dec 27, 2019

Last updated

Nov 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic Specialists of North America PLLCGroup PAC ID 7719014505, 310 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Orthopedic Specialists of North America, PLLC

  dba OrthoArizona

  • Orthopaedic Surgery Physician
  • Phoenix, AZ
  • NPI 1770812828
  Medicare reassignment Care Compare group NPD (past)
• Orthopedic Specialists of North America, PLLC

  • Orthopaedic Surgery Physician
  • Gilbert, AZ
  • NPI 1225350044
  NPD
• Orthopedic Specialists of North America, PLLC

  dba OrthoArizona

  • Orthopaedic Surgery Physician
  • Gilbert, AZ
  • NPI 1962292870
  NPD
• Center for Orthopedic Research and Education, LLC

  dba The CORE Institute

  • Orthopaedic Surgery Physician
  • Phoenix, AZ
  • NPI 1427095801

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1285273987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "602-772-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 E MELROSE ST STE 101-103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852971001",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7649 E Pinnacle Peak Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852556296",
            "country_code": "US",
            "telephone_number": "480-378-3983",
            "fax_number": "602-266-2927",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8410 W Thomas Rd Ste 138",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850373374",
            "country_code": "US",
            "telephone_number": "602-266-2272",
            "fax_number": "602-266-2272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIVERTS",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-27",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "7674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ARIZONA",
            "identifier": "7674",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donyell Sison, OD
• Courtney Sistak, CCC-SLP
• Nicole Alexandra Sistek, MSN, PMHNP-BC
• Meagan Rose Sitko, NP
• Micaela Sitzler
• Ellie J Sivill, LCPC, LPC
• Demi Skaggs, LPC
• Cally Skalko
• Tiffany Skarphol, LPC
• Dustin Skarupa, PHARMD

• Medical Physician Assistant in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.