Individual provider Active NPI

Jeffrey Louis Avery, PAC, MPAS

  • Physician Assistant
  • Vestal, NY
National Provider Identifier
1508835992
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007379-1 Issued in NY
Practice address
4433 Vestal Pkwy E
Vestal, NY 13850-3556
Phone
(607) 771-2220
Fax
(607) 251-2635
NPI assigned
Mar 16, 2006
Last updated
Dec 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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 MA003068L PA
Physician Assistant 363A00000X 007379-1 NY Primary

Addresses

Primary practice location

4433 Vestal Pkwy E
Vestal, NY 13850-3556

Mailing address

33 Lewis Rd Ste 2
Binghamton, NY 13905-1040
Phone (607) 729-8156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20091125000000 NY Practitioner - Physician Assistant 6204874480 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10 -24 Mitchell Ave
Binghamton, NY 13903-1617
Phone (607) 762-3131

33 -57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6101

4417 Vestal Pkwy E
Vestal, NY 13850-3556
Phone (607) 770-7365

4433 Vestal Pkwy E
Vestal, NY 13850-3556
Phone (607) 771-2220

52 Harrison St
Johnson City, NY 13790-2120
Phone (607) 763-5898

54 Main St
Candor, NY 13743-1619
Phone (607) 659-7272

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
86.74
Promoting interoperability
99
Improvement activities
40
Cost
70.09

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007379-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates, P.C. CurrentSince Nov 16, 2009 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Oct 23, 2011 Accepting new patients
Guthrie Medical Group, P.C. Past Accepting new patients

Locations

33 Lewis Rd
Ste 2
Binghamton, NY 13905

33 Mitchell Ave
#G50
Binghamton, NY 13903
Phone (607) 771-2220

33 Mitchell Ave
Ste G50
Binghamton, NY 13903
Phone (607) 771-2220

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

346 Grand Ave
Johnson City, NY 13790
Phone (607) 729-8156

4433 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 762-2176

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1508835992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LEWIS RD STE 2",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139051040",
            "telephone_number": "607-729-8156",
            "fax_number": "607-729-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4433 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503556",
            "telephone_number": "607-771-2220",
            "fax_number": "607-251-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "JEFFREY",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "PAC, MPAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA003068L",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007379-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.