Individual provider Active NPI

Jessica Lee Levasseur, PA-C

  • Surgical Physician Assistant
  • Prescott, AZ
National Provider Identifier
1669123055
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
11843 Issued in AZ
Practice address
1001 Willow Creek Rd Ste 3200
Prescott, AZ 86301-1614
Phone
(928) 771-5595
Fax
(928) 771-5596
NPI assigned
Jan 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 11843 AZ Primary
Surgical Physician Assistant 363AS0400X PA61263842 WA

Addresses

Primary practice location

1001 Willow Creek Rd Ste 3200
Prescott, AZ 86301-1614

Mailing address

844 Panorama RDG
Mount Vernon, WA 98273-9140

Other practice location 1

1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone (360) 428-2586

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlevasseur38378@skagit.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220426000166 WA Practitioner - Physician Assistant 0143617910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone (360) 428-2500

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 416-5750

211 S 13TH St
Mount Vernon, WA 98274-4107
Phone (360) 814-5900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61263842WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 1 Skagit CurrentSince Apr 12, 2022 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Apr 12, 2022 Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

Organizations & group practices 4

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 1

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": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1669123055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 PANORAMA RDG",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982739140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WILLOW CREEK RD STE 3200",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011614",
            "telephone_number": "928-771-5595",
            "fax_number": "928-771-5596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 E Kincaid St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744127",
            "country_code": "US",
            "telephone_number": "360-428-2586",
            "fax_number": "360-428-6470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVASSEUR",
        "first_name": "JESSICA",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-17",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "11843",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61263842",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlevasseur38378@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1400 E Kincaid St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.