Susan Elaine Jackson, RPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

015280 Issued in NY

Practice address

12 Leach Rd
Lyons, NY 14489-9732

Phone

(315) 946-6075

NPI assigned

Nov 10, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newark-Wayne Community Hospital Hospital, Newark, NY, CCN 330030
• Rochester General Hospital Hospital, Rochester, NY, CCN 330125

Merit-based Incentive Payment System (MIPS)

Final score

96.62 of 100Reported as apm

Quality

74.51

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjackson82766@direct.rochesterregional.org

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.

• Rochester General Hospital

  dba Rochester General Medical Groups

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1356412712
  Medicare reassignment Care Compare group
• Western New York Medical Practice P.C.

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1063790608
  Medicare reassignment NPD
• Newark Wayne Community Hospital

  • General Acute Care Hospital
  • Newark, NY
  • NPI 1770671182
  Medicare reassignment NPD (past)
• Clifton Springs Sanitarium Co

  dba Clifton Springs Hospital and Clinic

  • General Acute Care Hospital
  • Clifton Springs, NY
  • NPI 1366505463
  Medicare reassignment
• The Unity Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1760421713
  Medicare reassignment
• Newark Wayne Community Hospital

  • General Acute Care Hospital
  • Newark, NY
  • NPI 1346369212
  NPD
• The Unity Hospital of Rochester

  dba Unity Physician Services

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1457395766
  NPD
• Western New York Medical Practice, P.C.

  dba Rochester Regional Health Eye Care

  • Ophthalmology Physician
  • Rochester, NY
  • NPI 1891467486
  NPD

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

• Newark Wayne Community Hospital

  • General Acute Care Hospital
  • Newark, NY
  • NPI 1346369212
  Care Compare affiliation
• Newark Wayne Community Hospital

  • General Acute Care Hospital
  • Newark, NY
  • NPI 1770671182
  Care Compare affiliation

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1649557208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 LEACH RD",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144899732",
            "telephone_number": "315-946-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 LEACH RD",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144899732",
            "telephone_number": "315-946-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SUSAN",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-10",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "015280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Diane Howard, M.S.
• Melissa Hunter, LMSW
• Mary P. Hutchings, LPN
• Candice Ikeler
• Katelynn E Jackson, LPN
• Maria Lisa Jones, ASW, ICM
• Joseph J Russo DDS
• Jennifer Juby
• Alexandra Katchmar, LMSW
• Jy Thomas Kelley

• Medical Physician Assistant in Lyons, NY
• Providers in Lyons, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.