Individual provider Active NPI

Lexie Catherine Grimm Jackowski, PA

  • Physician Assistant
  • Cumberland, MD
National Provider Identifier
1689317596
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1050 W Industrial Blvd Ste 17
Cumberland, MD 21502-4331
Phone
(240) 964-9300
Fax
(240) 964-9310
NPI assigned
Apr 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1050 W Industrial Blvd Ste 17
Cumberland, MD 21502-4331

Mailing address

13406 Pershing St
Cumberland, MD 21502-5312
Phone (301) 471-4063

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lexie.c.grimm@upmcdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20231113003685 MD Practitioner - Physician Assistant 8921455924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upmc Western Maryland Health Services LLCGroup PAC ID 7113396011, 162 clinicians

Practice addresses (Care Compare)

1050 W Industrial Blvd
Cumberland, MD 21502-4331

10701 New Georges Creek Rd SW
Frostburg, MD 21532-1457

12500 Willowbrook Rd
Cumberland, MD 21502-6393
Phone (240) 964-6000

Hospital & facility affiliations

  • Western Maryland Regional Medical Center Hospital, Cumberland, MD, CCN 210027

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Western Maryland Health Services, LLC Single Specialty CurrentSince Sep 23, 2023 Accepting new patients
Upmc Western Maryland Health Services, LLC CurrentSince Sep 23, 2023 Accepting new patients

Locations

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

1050 W Industrial Blvd
Ste 17
Cumberland, MD 21502
Phone (240) 964-9300

Interoperability endpoints

  • Direct secure messaging: lgrimm106452@upmc.direct-ci.com

Organizations & group practices 3

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 4

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": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1689317596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13406 PERSHING ST",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215025312",
            "telephone_number": "301-471-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W INDUSTRIAL BLVD STE 17",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215024331",
            "telephone_number": "240-964-9300",
            "fax_number": "240-964-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKOWSKI",
        "first_name": "LEXIE",
        "middle_name": "CATHERINE GRIMM",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lexie.c.grimm@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

Verify at the official NPI Registry.