Individual provider Active NPI

Jessica Kaylor, PA-C

  • Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1760777858
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA060978 Issued in PA
Practice address
5770 Baum Blvd
Pittsburgh, PA 15206-3763
Phone
(412) 363-7546
NPI assigned
Jun 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00346900 NJ
Physician Assistant 363A00000X 014805-1 NY
Physician Assistant 363A00000X MA060978 PA Primary

Addresses

Primary practice location

5770 Baum Blvd
Pittsburgh, PA 15206-3763

Mailing address

133 Madison St
Hoboken, NJ 07030-7831
Phone (212) 283-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20151124000093 NJ Practitioner - Physician Assistant 1850529116 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014805NYMDMental Health Counselor
014805-1NYMDPhysician Assistant
MA060978PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Dermatology, LLC PastSince May 11, 2025 Accepting new patients

Organizations & group practices 3

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": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1760777858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 MADISON ST",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070307831",
            "telephone_number": "212-283-3000",
            "fax_number": "646-462-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 BAUM BLVD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152063763",
            "telephone_number": "412-363-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYLOR",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-16",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00346900",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014805-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA060978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.