Jaclyn Marie Siddall, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

23 015544 Issued in NY

Practice address

515 Main St
Exigence Medical of Olean Emergency Department
Olean, NY 14760-1513

Phone

(716) 373-2600

NPI assigned

Apr 10, 2012

Last updated

Mar 11, 2014By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jaclyn.siddall.1@30520.direct.athenahealth.com

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.

• Exigence Medical of Hornell, PLLC

  • Emergency Medicine Physician
  • Hornell, NY
  • NPI 1851528327
  NPD (past)
• Exigence Medical of Olean, PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Olean, NY
  • NPI 1609967744
  NPD (past)

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1437415841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 MAIN ST",
            "address_2": "EXIGENCE MEDICAL OF OLEAN EMERGENCY DEPARTMENT",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601513",
            "telephone_number": "716-373-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MAIN ST",
            "address_2": "EXIGENCE MEDICAL OF OLEAN EMERGENCY DEPARTMENT",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601513",
            "telephone_number": "716-373-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDALL",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "23 015544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Shelander, DPT
• Marieta Showers, LPN
• Jessica Shubert
• David S Shulman, M.D.
• Kay J Shults, RN
• Shazia Siddiqi, MD
• Katlin Marie Sikes, FNP-BC
• Susan K Simmons, NP
• Michele Beth Simon, AUD, FAAA
• Pamela Jean Simon, M.A. CCC-L SLP

• Physician Assistant in Olean, NY
• Providers in Olean, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.