Individual provider Active NPI

Jaclyn Nicole Finamore, PA-C

  • Physician Assistant
  • Boardman, OH
National Provider Identifier
1801136338
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003698 Issued in OH
Practice address
22 McClurg Rd
Boardman, OH 44512-6736
Phone
(330) 965-9400
Fax
(330) 953-3330
NPI assigned
Feb 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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 50.003698 OH Primary

Addresses

Primary practice location

22 McClurg Rd
Boardman, OH 44512-6736

Mailing address

22 McClurg Rd
Boardman, OH 44512-6736
Phone (330) 965-9400

Other identifiers 1

IdentifierTypeStateIssuer
50.003698OtherOHPENDING

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
I20130517000208 OH Practitioner - Physician Assistant 1153568852 Reassigns benefits to 1 organization

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
Patrick J Skarote MD IncGroup PAC ID 6103954730, 2 clinicians

Practice addresses (Care Compare)

22 McClurg Rd
Boardman, OH 44512-6736
Phone (330) 965-9400

Hospital & facility affiliations

  • Surgical Hospital at Southwoods Hospital, Youngstown, OH, CCN 360352
  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.003698OHMDPhysician Assistant

Organizations & group practices 1

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 3

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": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1801136338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MCCLURG RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126736",
            "telephone_number": "330-965-9400",
            "fax_number": "330-953-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MCCLURG RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126736",
            "telephone_number": "330-965-9400",
            "fax_number": "330-953-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINAMORE",
        "first_name": "JACLYN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-20",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENDING",
            "identifier": "50.003698",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.