Susannah Rose Jackson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.008544RX Issued in OH

Practice address

4000 Johnson Rd
Steubenville, OH 43952-2364

Phone

(740) 264-8039

Fax

(740) 264-8049

NPI assigned

Nov 16, 2021

Last updated

Feb 20, 2024By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA, OH, WV3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wheeling Hospital IncGroup PAC ID 5799689493, 433 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Medical Ctr East &Trinity Medical Ctr West Hospital, Steubenville, OH, CCN 360211
• Weirton Medical Center, Inc Hospital, Weirton, WV, CCN 510023
• Wheeling Hospital, Inc Hospital, Wheeling, WV, CCN 510050

Merit-based Incentive Payment System (MIPS)

Final score

93.9 of 100Reported as apm

Quality

85.02

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

73.74 of 100Reported as group

Quality

48.02

Promoting interoperability

91

Improvement activities

40

Cost

71.96

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Wheeling Hospital Inc

  • Family Medicine Physician
  • Wheeling, WV
  • NPI 1548923923
  Medicare reassignment Care Compare group NPD
• WMC Physician Practices LLC

  • Internal Medicine Physician
  • Burgettstown, PA
  • NPI 1518303288

  WV

  Medicare reassignment NPD
• Allegheny Clinic

  dba AHN-Primary Care Bethel Park

  • Family Medicine Physician
  • Bethel Park, PA
  • NPI 1073081493
  Medicare reassignment
• Trinity West

  dba Trinity Family Care Centers

  • Rural Health Clinic/Center
  • Cadiz, OH
  • NPI 1316789506
  NPD
• Allegheny Clinic

  dba AHN Primary Care Mobile Clinic

  • Primary Care Clinic/Center
  • Pittsburgh, PA
  • NPI 1215752548
  NPD
• Allegheny Clinic

  dba AHN Surgery

  • Surgery Physician
  • Pittsburgh, PA
  • NPI 1568462984
  NPD
• WMC Physician Practices LLC

  • Internal Medicine Physician
  • Weirton, WV
  • NPI 1104280213
  NPD

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

• Trinity Hospital Holding Company

  dba Acute Care West

  • General Acute Care Hospital
  • Steubenville, OH
  • NPI 1285715144
  Care Compare affiliation
• Weirton Medical Center, Inc

  dba Weirton Medial Center

  • General Acute Care Hospital
  • Weirton, WV
  • NPI 1619921947
  Care Compare affiliation
• Wheeling Hospital Inc

  • General Acute Care Hospital
  • Wheeling, WV
  • NPI 1104821305
  Care Compare affiliation

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1548926306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 SUMMIT AVENUE",
            "address_2": "MSO PHYSICIAN BILLING",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "439522667",
            "telephone_number": "740-428-3175",
            "fax_number": "740-283-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 JOHNSON RD",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "439522364",
            "telephone_number": "740-264-8039",
            "fax_number": "740-264-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SUSANNAH",
        "middle_name": "ROSE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-16",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008544RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035572",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kellee M Isaly
• Edward C Isla, MD
• Samuel Anthony Ivkovich, MA, LPC, NCC
• Pritish Iyer
• Katherine R. Jackson, PT
• Zachary Jackson, DO
• Joanna Sarah Jacob, MBBS
• Jenna M Jafrate, CRNA
• Edward J. Jagela, O.D., F.A.A.O.
• Nasrollah Jahdi, MD

• Physician Assistant in Steubenville, OH
• Providers in Steubenville, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.