NPIMap

Individual provider Active NPI

Andrea Jackson, PA-C

  • Physician Assistant
  • Grove City, PA
National Provider Identifier
1558864132
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA059472 Issued in PA
Practice address
631 N Broad Street Ext
Grove City, PA 16127-4603
Phone
(724) 450-7246
NPI assigned
Mar 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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
Physician Assistant 363A00000X MA059472 PA Primary

Addresses

Primary practice location

631 N Broad Street Ext
Grove City, PA 16127-4603

Mailing address

631 N Broad Street Ext
Grove City, PA 16127-4603
Phone (724) 450-7246

Other names 1

  • Andrea Hoover Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180531000981 PA Practitioner - Physician Assistant 8820353469 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allegheny ClinicGroup PAC ID 5395649586, 2,313 clinicians

Practice addresses (Care Compare)

12311 Perry Hwy
Wexford, PA 15090-8344
Phone (412) 359-3457

12351 Perry Hwy
Wexford, PA 15090-8344
Phone (412) 359-6581

320 E N Ave
Pittsburgh, PA 15212-4756

4800 Friendship Ave
Pittsburgh, PA 15224-1722

631 N Broad St Ext
Grove City, PA 16127-4603

631 N Broad St Extension
Agh Radiation Oncology
Grove City, PA 16127-4603
Phone (724) 450-7182

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA059472PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mon Vale Clinical Professionals, Inc. CurrentSince Jul 1, 2020 Accepting new patients
Allegheny Clinic CurrentSince Apr 6, 2022 Accepting new patients
University of Pittsburgh Physicians CurrentSince Apr 23, 2018 Accepting new patients
University of Pittsburgh Physicians CurrentSince Apr 23, 2018 Accepting new patients
Allegheny Clinic CurrentSince Apr 6, 2022 Accepting new patients

Locations

631 N Broad Street Ext
Grove City, PA 16127
Phone (724) 450-7000

1163 Country Club Rd
Monongahela, PA 15063
Phone (724) 258-1000

4800 Friendship Ave
Pittsburgh, PA 15224
Phone (412) 359-3030

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

12351 Perry Hwy
Wexford, PA 15090
Phone (412) 359-3030

Interoperability endpoints

  • Direct secure messaging: ajackson476071@direct.ahn.org

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1558864132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 N BROAD STREET EXT",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161274603",
            "telephone_number": "724-450-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 N BROAD STREET EXT",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161274603",
            "telephone_number": "724-450-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANDREA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-09",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "HOOVER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grove City, PA

Sources for this page

Verify at the official NPI Registry.