Jackie Mae Anderson, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

312232 Issued in NY

Practice address

601 Elmwood Ave
Rochester, NY 14642-4200

Phone

(585) 275-9555

Fax

(585) 473-3516

NPI assigned

Jun 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Jackie Mae Grimes Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NY, PA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Philadelphia College of Osteopathic Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dubois Regional Medical CenterGroup PAC ID 5890689715, 424 clinicians

St James HospitalGroup PAC ID 0345154480, 130 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• NOYES CENTER for KIDNEY DISEASE and DIALYSIS Dialysis facility, Geneseo, NY, CCN 333553
• Penn Highlands Mon Valley Hospital, Monongahela, PA, CCN 390147
• Penn Highlands Connellsville Hospital, Connellsville, PA, CCN 390184
• St James Hospital Hospital, Hornell, NY, CCN 330151

Merit-based Incentive Payment System (MIPS)

Final score

83.2 of 100Reported as group

Quality

60.03

Promoting interoperability

99

Improvement activities

40

Cost

73.33

Merit-based Incentive Payment System (MIPS)

Final score

96.6 of 100Reported as group

Promoting interoperability

96

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

87.99 of 100Reported as group

Quality

77.37

Promoting interoperability

99

Improvement activities

40

Cost

71.18

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: janderson230326@direct.urmc.rochester.edu

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.

• St James Hospital

  • Rural Acute Care Hospital
  • Hornell, NY
  • NPI 1013985399
  Medicare reassignment Care Compare group NPD
• Dubois Regional Medical Center

  • Emergency Medicine Physician
  • Du Bois, PA
  • NPI 1992802391
  Medicare reassignment Care Compare group NPD
• Emergency Associates - University of Rochester

  • Emergency Care Clinic/Center
  • Rochester, NY
  • NPI 1346281268
  Medicare reassignment NPD
• Nicholas H. Noyes Memorial Hospital

  • General Acute Care Hospital
  • Dansville, NY
  • NPI 1982625661
  Medicare reassignment NPD
• Observation Associates of the University of Rochester

  • Multi-Specialty Clinic/Center
  • Rochester, NY
  • NPI 1518908433
  Medicare reassignment NPD
• The Memorial Hospital of William F. and Gertrude F. Jones, Inc.

  • General Acute Care Hospital
  • Wellsville, NY
  • NPI 1720030703
  Medicare reassignment NPD
• The Memorial Hospital of William F. and Gertrude F. Jones, Inc.

  • Rural Health Clinic/Center
  • Hornell, NY
  • NPI 1457974644
  NPD
• Dubois Regional Medical Center

  • Pharmacy
  • Ridgway, PA
  • NPI 1366900458
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St James Hospital

  • Rural Acute Care Hospital
  • Hornell, NY
  • NPI 1013985399
  Care Compare affiliation
• Highlands Hospital and Health Center

  • Psychiatric Hospital Unit
  • Connellsville, PA
  • NPI 1124053467
  Care Compare affiliation
• Highlands Hospital and Health Center

  • General Acute Care Hospital
  • Connellsville, PA
  • NPI 1144215039
  Care Compare affiliation
• Highlands Hospital and Health Center

  • Internal Medicine Physician
  • Connellsville, PA
  • NPI 1518680164

  Hospital

  Care Compare affiliation
• Monongahela Valley Hospital, Inc

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Monongahela, PA
  • NPI 1184401259
  Care Compare affiliation
• Monongahela Valley Hospital, Inc.

  • General Acute Care Hospital
  • Monongahela, PA
  • NPI 1639353428
  Care Compare affiliation
• Monongahela Valley Hospital, Inc.

  • General Acute Care Hospital
  • Monongahela, PA
  • NPI 1912905548
  Care Compare affiliation

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1447789565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVENUE BOX 655",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146428655",
            "telephone_number": "585-273-4398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146424200",
            "telephone_number": "585-275-9555",
            "fax_number": "585-473-3516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JACKIE",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2023-07-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "PA",
            "license": "OT018082",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "312232",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "312232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "janderson230326@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "janderson230326@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "GRIMES",
            "middle_name": "MAE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Donald Anderson, LMHC
• Eldrie A Anderson
• Hannah Elizabeth Anderson, PA-C
• Heather Marie Anderson, CASAC-T
• Hester Anderson
• Jamie L Anderson, PAC
• Jared Joseph Anderson, D.C.
• Jennifer Lynn Anderson
• Kevonna Lynessa Anderson, LPN
• Kristopher W Anderson

• Emergency Medicine Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.