Jason M Lightbody, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

011634 Issued in NY

Practice address

3400 Bainbridge Ave
5TH Floor
Bronx, NY 10467

Phone

(718) 920-4896

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jlightbody49153@northwell.direct-ci.com

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1831266964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 PURCHASE ST APT K",
            "city": "RYE",
            "state": "NY",
            "postal_code": "105802148",
            "telephone_number": "914-497-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BAINBRIDGE AVE",
            "address_2": "5TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTBODY",
        "first_name": "JASON",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "011634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Life Star Pharmacy Inc.
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• Lifespire, Inc.
• Lifestyle Solutions, Inc.
• Jill Light
• Shawn Lightburn, LMSW
• Lighthouse Mental Health Counseling, PC
• Miriam Lightman
• Linda Edelstein Lightstone, MSW
• Ricarte Ligsay, PT

• Surgical Physician Assistant in Bronx, NY
• Providers in Bronx, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.