Active NPI
Jennifer L Nyitray, PA
- Physician Assistant
- Saint Marys, OH
National Provider Identifier
1740250968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1959
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0068216 | Medicaid | OH |
Other names 1
- Jennifer L Jacobs
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
Enrollment records 1
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
Practice addresses (Care Compare)
200 Saint Clair Ave
Saint Marys, OH 45885-2400
Phone 41939433353569
Hospital & facility affiliations
- Grand Lake Health System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1959 | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New 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
- jennifernyitray@glhs.allscriptsdirect.net
- 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.
-
- General Acute Care Hospital
- Saint Marys, OH
- NPI 1639133002
-
- Surgery Physician
- Lima, OH
- NPI 1518589803
-
- Family Medicine Physician
- Lima, OH
- NPI 1225292865
-
- Home Health Agency
- St Marys, OH
- NPI 1811951817
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Marys, OH
- NPI 1639133002
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.