Individual provider Active NPI

Jesse Hanks, PA-C

  • Physician Assistant
  • Jackson, MS
National Provider Identifier
1306434477
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
501 Marshall St Ste 600
Jackson, MS 39202-1650
Phone
(601) 990-4126
NPI assigned
Jan 5, 2021
Last updated
Apr 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

501 Marshall St Ste 600
Jackson, MS 39202-1650

Mailing address

PO Box 13786
Jackson, MS 39236-3786
Phone (601) 618-1718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20210423001218 MS Practitioner - Physician Assistant 4981012358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Urogyn LLCGroup PAC ID 7517197718, 9 clinicians

Practice addresses (Care Compare)

1040 River Oaks Dr
Flowood, MS 39232-9531
Phone (601) 948-6540

111 Colony Crossing Way
Suite 250
Madison, MS 39110-6832
Phone (601) 326-6401

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.89 of 100Reported as group
Quality
49.43
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urogyn Diagnostics LLC PastSince Apr 25, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jesse.hanks.1@30135.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1306434477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13786",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392363786",
            "telephone_number": "601-618-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST STE 600",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021650",
            "telephone_number": "601-990-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANKS",
        "first_name": "JESSE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.