Individual provider Active NPI

Jason S. Misel, PA-C

  • Medical Physician Assistant
  • Shippensburg, PA
National Provider Identifier
1518375435
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA057080 Issued in PA
Practice address
46 Walnut Bottom Rd
Suite 200
Shippensburg, PA 17257-8219
Phone
(717) 532-4148
Fax
(717) 532-3561
NPI assigned
Jul 23, 2014
Last updated
Jan 3, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA057080 PA Primary

Addresses

Primary practice location

46 Walnut Bottom Rd
Suite 200
Shippensburg, PA 17257-8219

Mailing address

785 5TH Ave
Suite 3
Chambersburg, PA 17201-4232
Phone (717) 263-9555

Other identifiers 2

IdentifierTypeStateIssuer
103220252MedicaidPA
867633OtherPAMEDICARE GROUP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20181227001172 FL Practitioner - Physician Assistant 9638391188 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Solantic of Jacksonville LLCGroup PAC ID 1052409307, 56 clinicians

Practice addresses (Care Compare)

1021 Cesery Blvd
Jacksonville, FL 32211-5609
Phone (615) 600-4074

2401 Monument Rd
Jacksonville, FL 32225-2520
Phone (904) 642-0337

4498 Hendricks Ave
Jacksonville, FL 32207-6326
Phone (615) 600-4074

5964 Normandy Blvd
Carespot Express Healthcare
Jacksonville, FL 32205-6212
Phone (615) 600-4074

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Nov 5, 2018 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Nov 5, 2018 Accepting new patients
Solantic of Jacksonville, LLC PastSince Sep 5, 2021 Accepting new patients

Locations

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

Organizations & group practices 5

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": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1518375435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 5TH AVE",
            "address_2": "SUITE 3",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014232",
            "telephone_number": "717-263-9555",
            "fax_number": "717-217-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 WALNUT BOTTOM RD",
            "address_2": "SUITE 200",
            "city": "SHIPPENSBURG",
            "state": "PA",
            "postal_code": "172578219",
            "telephone_number": "717-532-4148",
            "fax_number": "717-532-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISEL",
        "first_name": "JASON",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-23",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103220252",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "867633",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shippensburg, PA

Sources for this page

Verify at the official NPI Registry.