Individual provider Active NPI

Jazmyne Shiann Shaffer, PA-C

  • Physician Assistant
  • Erie, PA
National Provider Identifier
1699265793
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA004529 Issued in PA
Practice address
3330 Peach St Ste 106B
Erie, PA 16508-2771
Phone
(814) 877-5770
Fax
(814) 877-5771
NPI assigned
May 14, 2018
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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 OA004529 PA Primary
Physician Assistant 363A00000X MA059902 PA

Addresses

Primary practice location

3330 Peach St Ste 106B
Erie, PA 16508-2771

Mailing address

3330 Peach St Ste 106B
Erie, PA 16508-2771
Phone (814) 877-5770

Other names 1

  • Jazmyne Shiann Sasse Former name

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
I20180917001585 PA Practitioner - Physician Assistant 9830440791 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regional Health Services IncGroup PAC ID 4880593722, 572 clinicians

Practice addresses (Care Compare)

3330 Peach St
Suite 107
Erie, PA 16508-2771
Phone (814) 877-5500

3406 Peach St
Erie, PA 16508-2740
Phone (814) 877-5381

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA059902PAMDPhysician Assistant
OA004529PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Care Services of Pennsylvania, P.C. Physician Assistant CurrentSince Mar 21, 2020 Accepting new patients
Geisinger Clinic CurrentSince Dec 4, 2018 Accepting new patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Mar 22, 2021 Accepting new patients
Geisinger Clinic CurrentSince Dec 4, 2018 Accepting new patients

Locations

42 N Scott St
Carbondale, PA 18407
Phone (570) 282-6660

100 N Academy Ave
Danville, PA 17822

21 Geisinger Ln
Lewistown, PA 17044
Phone (717) 242-4200

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

611 University Dr
State College, PA 16801
Phone (814) 234-2600

Interoperability endpoints

  • Direct secure messaging: jazmyne.shaffer@upmcdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1699265793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 PEACH ST STE 106B",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082771",
            "telephone_number": "814-877-5770",
            "fax_number": "814-877-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 PEACH ST STE 106B",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082771",
            "telephone_number": "814-877-5770",
            "fax_number": "814-877-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "JAZMYNE",
        "middle_name": "SHIANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA004529",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059902",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAZMYNE",
            "last_name": "SASSE",
            "middle_name": "SHIANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.