Individual provider Active NPI

Ashlynn Nicole Jessen, PA

  • Physician Assistant
  • Williamsport, PA
National Provider Identifier
1801357678
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1201 Grampian Blvd Ste 2F
Williamsport, PA 17701-1965
Phone
(570) 321-2020
Fax
(570) 320-7455
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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 Primary

Addresses

Primary practice location

1201 Grampian Blvd Ste 2F
Williamsport, PA 17701-1965

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20220524001384 OK Practitioner - Physician Assistant 8224370077 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tulsa Hospital Medicine Physicians Group, LLCGroup PAC ID 7214327832, 132 clinicians

Practice addresses (Care Compare)

1027 E Cherry St
Cushing, OK 74023-4101
Phone (918) 225-2915

10502 N 110TH E Ave
Bailey Medical Center
Owasso, OK 74055-6655
Phone (918) 579-2300

1120 S Utica Ave
Hillcrest Medical Center
Tulsa, OK 74104-4012
Phone (918) 579-1000

6901 S Olympia Ave
Tulsa Spine and Specialty Hospital
Tulsa, OK 74132-1843
Phone (918) 388-5701

8801 S 101St E Ave
Hillcrest Hospital South
Tulsa, OK 74133-5716
Phone (919) 294-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.31 of 100Reported as group
Improvement activities
20
Cost
82.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4632OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Infectious Disease Specialists, LLC CurrentSince Jan 14, 2026 Accepting new patients
Leflore County Hospital Authority Past Accepting new patients

Locations

10502 N 110th East Ave
Owasso, OK 74055
Phone (918) 376-8000

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

Interoperability endpoints

  • Direct secure messaging: arice556307@ahs.direct-ci.com

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.

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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1801357678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD STE 2F",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011965",
            "telephone_number": "570-321-2020",
            "fax_number": "570-320-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSEN",
        "first_name": "ASHLYNN",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.