Kerri A Jack, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA002234L Issued in PA

Practice address

5115 Centre Ave
Pittsburgh, PA 15232-1301

Phone

(412) 647-2811

NPI assigned

Mar 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Pittsburgh PhysiciansGroup PAC ID 8729990239, 4,166 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.94 of 100Reported as group

Quality

61.89

Promoting interoperability

100

Improvement activities

40

Cost

74.58

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 and National Provider Directory roles.

• University of Pittsburgh Physicians

  • Gastroenterology Physician
  • Pittsburgh, PA
  • NPI 1619935004
  Medicare reassignment Care Compare group
• University of Pittsburgh Physicians

  • Diagnostic Radiology Physician
  • Pittsburgh, PA
  • NPI 1285692699
  NPD
• University of Pittsburgh Physicians

  • Hematology & Oncology Physician
  • Pittsburgh, PA
  • NPI 1407804057
  NPD
• Genesis Medical Associates, Inc

  • Family Medicine Physician
  • Pittsburgh, PA
  • NPI 1477603314
  NPD (past)

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1407823958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 LYNN ANN DR",
            "city": "NEW KENSINGTON",
            "state": "PA",
            "postal_code": "150689382",
            "telephone_number": "724-882-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 CENTRE AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152321301",
            "telephone_number": "412-647-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "KERRI",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA002234L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Demos, M.D., Inc.
• Jack L Malvin Dental Associates, PC
• Danielle N. Jack
• David Jack, RPH
• Jessica Paige Jack, MSW
• Lauren Jack
• Katie Jackley, PA-C
• Larissa Ann Jackline, CRNP
• Gale M Jackman, CRNA
• Stephen Jackman

• Medical Physician Assistant in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.