Active NPI
Jessica Kaylor, PA-C
- Physician Assistant
- Pittsburgh, PA
National Provider Identifier
1760777858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA060978
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014805 | NY | MD | Mental Health Counselor |
| 014805-1 | NY | MD | Physician Assistant |
| MA060978 | PA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clark Dermatology, LLC | Past | 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.
-
- Dermatology Physician
- Paramus, NJ
- NPI 1194051243
-
dba Metropolitan Dermatology
- Dermatology Physician
- Staten Island, NY
- NPI 1417316274
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.