Individual provider Active NPI

Jocelyn McKeithan

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1407160484
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA066167 Issued in PA
Practice address
150 55TH Street
Brooklyn, NY 11220-2559
Phone
(718) 630-7185
NPI assigned
Aug 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA066167 PA Primary
Physician Assistant 363A00000X 014052 NY

Addresses

Primary practice location

150 55TH Street
Brooklyn, NY 11220-2559

Mailing address

606 Broadway
Paterson, NJ 07514-1916
Phone (908) 240-8142

Other practice location 1

700 E Norwegian St
Pottsville, PA 17901-2710
Phone (570) 621-4090

Other identifiers 1

IdentifierTypeStateIssuer
104438717-0001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110707000195 NJ Practitioner - Physician Assistant 6901089200 Reassigns benefits to 5 organizations
I20250203002350 PA Practitioner - Physician Assistant 6901089200 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince May 16, 2011 Accepting new patients
The Radiology Group of New Jersey, LLC Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

Interoperability endpoints

  • Direct secure messaging: jmckeithan1391578@direct2.lvhn.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1407160484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 BROADWAY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075141916",
            "telephone_number": "908-240-8142",
            "fax_number": "908-240-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 55TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202559",
            "telephone_number": "718-630-7185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 E Norwegian St",
            "address_purpose": "LOCATION",
            "city": "Pottsville",
            "state": "PA",
            "postal_code": "179012710",
            "country_code": "US",
            "telephone_number": "570-621-4090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKEITHAN",
        "first_name": "JOCELYN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-02",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066167",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014052",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104438717-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.