Individual provider Active NPI

Jessie L Wood, PA

  • Medical Physician Assistant
  • Manchester, NH
National Provider Identifier
1760729735
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0956 Issued in NH
Practice address
100 Hitchcock Way
Family Medicine
Manchester, NH 03104-4125
Phone
(603) 629-1870
NPI assigned
Jan 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0956 NH Primary

Addresses

Primary practice location

100 Hitchcock Way
Family Medicine
Manchester, NH 03104-4125

Mailing address

100 Hitchcock Way
Family Medicine
Manchester, NH 03104-4125
Phone (603) 629-1870

Other identifiers 1

IdentifierTypeStateIssuer
3090879MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20140722000151 NH Practitioner - Physician Assistant 0840437638 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

100 Hitchcock Way
Manchester, NH 03104-4125
Phone (603) 695-2500

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0956NHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic CurrentSince Jun 3, 2014 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 1, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jun 3, 2014 Accepting new patients
Mary Hitchcock Memorial Hospital Past Accepting new patients

Locations

58 Hawthorne Dr
Bedford, NH 03110
Phone (603) 232-5922

25 S River Rd
Bedford, NH 03110
Phone (603) 626-4392

253 Pleasant St
Concord, NH 03301
Phone (603) 226-2200

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

100 Hitchcock Way
Manchester, NH 03104
Phone (603) 629-1870

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1760729735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HITCHCOCK WAY",
            "address_2": "FAMILY MEDICINE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031044125",
            "telephone_number": "603-629-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HITCHCOCK WAY",
            "address_2": "FAMILY MEDICINE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031044125",
            "telephone_number": "603-629-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "JESSIE",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "0956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3090879",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.