Individual provider Active NPI

Jacklyn Rae Hucke, PA-C

  • Physician Assistant
  • Upper Arlington, OH
National Provider Identifier
1790555951
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.008571RX Issued in OH
Practice address
4605 Sawmill Rd
Upper Arlington, OH 43220-2246
Phone
(614) 827-8700
Fax
(614) 827-8701
NPI assigned
Jan 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 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 50.008571RX OH Primary

Addresses

Primary practice location

4605 Sawmill Rd
Upper Arlington, OH 43220-2246

Mailing address

340 Polaris Pkwy
Westerville, OH 43082-7971

Other names 1

  • Jacklyn Rae Fontana Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240220002457 OH Practitioner - Physician Assistant 5294179040 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians
Orthopedic One, Inc.Group PAC ID 3072598283, 282 clinicians

Practice addresses (Care Compare)

111 S Grant Ave
Columbus, OH 43215-4701

111 S Grant Ave 3Rd FL
Columbus, OH 43215-4701
Phone (614) 566-9184

393 E Town St
Columbus, OH 43215-4799

4605 Sawmill Rd
Upper Arlington, OH 43220-2246
Phone (614) 827-8700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic One, Inc CurrentSince Dec 5, 2025 Accepting new patients
Ohiohealth Corporation CurrentSince Mar 1, 2024 Accepting new patients
Orthopedic One, Inc. CurrentSince Dec 5, 2025 Accepting new patients
Ohiohealth Corporation CurrentSince Mar 1, 2024 Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

285 E State St
Ste 260
Columbus, OH 43215
Phone (614) 566-9035

Dept L3652
Columbus, OH 43260

4604 Sawmill Rd
Upper Arlngtn, OH 43220
Phone (614) 839-2300

4605 Sawmill Rd
Upper Arlngtn, OH 43220
Phone (614) 827-1050

340 Polaris Pkwy
Westerville, OH 43082
Phone (614) 839-2300

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1790555951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 POLARIS PKWY",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430827971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 SAWMILL RD",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432202246",
            "telephone_number": "614-827-8700",
            "fax_number": "614-827-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCKE",
        "first_name": "JACKLYN",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008571RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKLYN",
            "last_name": "FONTANA",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Upper Arlington, OH

Sources for this page

Verify at the official NPI Registry.