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Individual provider Active NPI

Jill Diane Nelson, PA-C

  • Physician Assistant
  • Olean, NY
National Provider Identifier
1790816015
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012348 Issued in NY
Practice address
535 Main St
Olean, NY 14760-1500
Phone
(716) 372-0141
Fax
(716) 376-2225
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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 012348 NY Primary

Addresses

Primary practice location

535 Main St
Olean, NY 14760-1500

Mailing address

535 Main St
Olean, NY 14760-1500
Phone (716) 372-0141

Other identifiers 1

IdentifierTypeStateIssuer
2550OtherAZAZ LICENSE

Other names 1

  • Jill Diane Nelson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080125000563 NY Practitioner - Physician Assistant 4981786233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians
Olean Medical Practice PLLCGroup PAC ID 0042698045, 56 clinicians

Practice addresses (Care Compare)

535 Main St
Olean, NY 14760-1500
Phone (716) 372-0141

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Jan 1, 2024 Accepting new patients
General Physician, PC CurrentSince Jan 1, 2024 Accepting new patients
General Physician, PC Past Accepting new patients

Locations

535 Main St
Olean, NY 14760
Phone (716) 372-0141

535 Main St
Ste 1
Olean, NY 14760
Phone (716) 372-0141

195 Pleasant St
Unit 2
Bradford, PA 16701
Phone (814) 362-5503

195 Pleasant St
Bradford, PA 16701
Phone (814) 362-4966

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.

Hospital & facility affiliations 8

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1790816015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 MAIN ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601500",
            "telephone_number": "716-372-0141",
            "fax_number": "716-376-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 MAIN ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601500",
            "telephone_number": "716-372-0141",
            "fax_number": "716-376-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JILL",
        "middle_name": "DIANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "2550",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "NELSON",
            "middle_name": "DIANE",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Olean, NY

Sources for this page

Verify at the official NPI Registry.