NPIMap

Individual provider Active NPI

Jessica A Stubbs, PA-C

  • Physician Assistant
  • New Haven, CT
National Provider Identifier
1407303308
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(570) 905-6939
NPI assigned
Sep 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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 4957 CT
Physician Assistant 363A00000X PA Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

20 York St
New Haven, CT 06510-3220
Phone (570) 905-6939

Other practice location 1

1 Guthrie Sq
Sayre, PA 18840-1625
Phone (570) 887-2300

Other names 1

  • Jessica A Pavlikowski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161105000036 PA Practitioner - Physician Assistant 1951689397 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

1800 Mulberry St
Scranton, PA 18510-2369
Phone (570) 969-7355

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Oct 17, 2022 Accepting new patients
Family Care Centers Inc. CurrentSince Nov 14, 2022 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Oct 3, 2016 Accepting new patients
Geisinger Clinic CurrentSince Oct 17, 2022 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Oct 3, 2016 Accepting new patients
Guthrie Medical Group PC Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

Interoperability endpoints

  • Direct secure messaging: jpavlikowski91225@direct-guthrie.org

Organizations & group practices 9

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.

Hospital & facility affiliations 11

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": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1407303308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "570-905-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "570-905-6939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Guthrie Sq",
            "address_purpose": "LOCATION",
            "city": "Sayre",
            "state": "PA",
            "postal_code": "188401625",
            "country_code": "US",
            "telephone_number": "570-887-2300",
            "fax_number": "570-887-2882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUBBS",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4957",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "PAVLIKOWSKI",
            "middle_name": "A",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.