Individual provider Active NPI

Jennifer L Nyitray, PA

  • Physician Assistant
  • Saint Marys, OH
National Provider Identifier
1740250968
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1959 Issued in OH
Practice address
975 Hager St
Saint Marys, OH 45885-2420
Phone
(419) 394-9992
Fax
(419) 394-9629
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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 1959 OH Primary

Addresses

Primary practice location

975 Hager St
Saint Marys, OH 45885-2420

Mailing address

200 Saint Clair Ave
Saint Marys, OH 45885-2494
Phone (419) 394-3335

Other identifiers 1

IdentifierTypeStateIssuer
0068216MedicaidOH

Other names 1

  • Jennifer L Jacobs Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20050908000026 OH Practitioner - Physician Assistant 7315979622 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joint Township District Memorial HospitalGroup PAC ID 3870491590, 39 clinicians

Practice addresses (Care Compare)

200 Saint Clair Ave
Saint Marys, OH 45885-2400
Phone 41939433353569

Hospital & facility affiliations

  • Grand Lake Health System Hospital, Saint Marys, OH, CCN 360032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1959OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
JTDM Family Practice LLC Physician Assistant Past Accepting new patients
Joint Township District Memorial Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jennifernyitray@glhs.allscriptsdirect.net
  • Direct secure messaging: jjacobs39516@direct.bsmhealth.org

Organizations & group practices 6

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1740250968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SAINT CLAIR AVE",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852494",
            "telephone_number": "419-394-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 HAGER ST",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852420",
            "telephone_number": "419-394-9992",
            "fax_number": "419-394-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYITRAY",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "1959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068216",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "JACOBS",
            "middle_name": "L",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Marys, OH

Sources for this page

Verify at the official NPI Registry.