Individual provider Active NPI

Jane Jesse, MD

  • Psychiatry Physician
  • Kingston, PA
National Provider Identifier
1508060112
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD435626 Issued in PA
Practice address
480 Pierce St Ste 320
Kingston, PA 18704-5512
Phone
(570) 690-5159
NPI assigned
Jun 14, 2007
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD435626 PA Primary

Addresses

Primary practice location

480 Pierce St Ste 320
Kingston, PA 18704-5512

Mailing address

480 Pierce St Ste 320
Kingston, PA 18704-5512
Phone (570) 690-5159

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110520000667 PA Practitioner - Psychiatry 0648456913 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

480 Pierce St
Suite 103
Kingston, PA 18704-5512
Phone (570) 820-8888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatry CurrentSince Aug 15, 2024 Accepting new patients
Wyoming Valley Alcohol and Drug Services Inc CurrentSince May 27, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

480 Pierce St
Ste 103
Kingston, PA 18704
Phone (570) 820-8888

480 Pierce St
Ste 113
Kingston, PA 18704
Phone (570) 820-8888

1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177

437 N Main St
Wilkes Barre, PA 18705
Phone (570) 820-8888

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1508060112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 PIERCE ST STE 320",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045512",
            "telephone_number": "570-690-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 PIERCE ST STE 320",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045512",
            "telephone_number": "570-690-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSE",
        "first_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD435626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

Verify at the official NPI Registry.