Individual provider Active NPI

Jacqueline Elise Barth, PA-C

  • Physician Assistant
  • Worcester, MA
National Provider Identifier
1750096202
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
309 Belmont St
Worcester, MA 01604-1059
Phone
(508) 368-3300
NPI assigned
Jan 19, 2023
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 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 Primary

Addresses

Primary practice location

309 Belmont St
Worcester, MA 01604-1059

Mailing address

309 Belmont St
Worcester, MA 01604-1059
Phone (508) 368-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20230427000964 MA Practitioner - Physician Assistant 8628433679 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts Physician Assistant CurrentSince Oct 3, 2024 Accepting new patients
The Commonwealth of Massachusetts CurrentSince Oct 3, 2024 Accepting new patients

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1750096202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041059",
            "telephone_number": "508-368-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041059",
            "telephone_number": "508-368-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTH",
        "first_name": "JACQUELINE",
        "middle_name": "ELISE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.