Individual provider Active NPI

Rachel Hil Jackson, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1609470517
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA062140 Issued in PA
Practice address
801 Spruce St FL 3
Philadelphia, PA 19107-5701
Phone
(215) 829-2222
Fax
(215) 829-2492
NPI assigned
Nov 23, 2020
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA062140 PA Primary

Addresses

Primary practice location

801 Spruce St FL 3
Philadelphia, PA 19107-5701

Mailing address

801 Spruce St FL 3
Philadelphia, PA 19107-5701
Phone (215) 829-2222

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201210000393 PA Practitioner - Physician Assistant 1759793037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Jefferson Medical College of Thomas Jefferson University, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

145 King of Prussia Rd
Radnor, PA 19087-4557

145 King of Prussia Rd 201
Radnor, PA 19087-4557

145 King of Prussia Rd 203
Radnor, PA 19087-4557

145 King of Prussia Rd 302
GYN/Onc Radnor
Radnor, PA 19087-4557
Phone (610) 902-2500

145 King of Prussia Rd N
G102 Oto Surgery Radnor
Philadelphia, PA 19087-4557
Phone (610) 902-5500

145 King of Prussia Rd N G
1 Rad Onc Rdanor
Radnor, PA 19087-4557
Phone (610) 902-4580

145 King of Prussia Road G-103
Oral/Maxillo Surg Radnor
Radnor, PA 19087-4557
Phone (610) 902-2100

3400 Spruce St
Philadelphia, PA 19104-4206

3400 Spruce Street 5 White BLDG
Oral and Maxillofacial Surgery Hup
Philadelphia, PA 19104-4206
Phone (215) 829-6079

800 Spruce St
Philadelphia, PA 19107-6130

800 Spruce St Cathcart Building
Penn Radiology Mobile Mammography Pennsylva
Philadelphia, PA 19107-6130
Phone (215) 829-3282

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA062140PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Dec 4, 2020 Accepting new patients

Locations

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

801 Spruce St
Fl 3
Philadelphia, PA 19107
Phone (215) 627-5272

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.

Hospital & facility affiliations 6

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": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1609470517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SPRUCE ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075701",
            "telephone_number": "215-829-2222",
            "fax_number": "215-829-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 SPRUCE ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075701",
            "telephone_number": "215-829-2222",
            "fax_number": "215-829-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RACHEL",
        "middle_name": "HIL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.