Abbe Michele Clyde, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA061783 Issued in PA

Practice address

606 Community Way
Lancaster, PA 17603-2329

Phone

(610) 687-8771

NPI assigned

Aug 6, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Abbe Michele Jackson Former name

Medicare fee-for-service enrollment

Enrolled in NY, PA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Morgenstern Center for Orbital and Facial Plastic Surgery, IncGroup PAC ID 7810992252, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Morgenstern Center for Orbital and Facial Plastic Surgery, Inc.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Wayne, PA
  • NPI 1700824752
  Medicare reassignment Care Compare group
• Heron Rock Surgery Center of Lancaster

  • Ambulatory Surgical Clinic/Center
  • Lancaster, PA
  • NPI 1023875887
  Medicare reassignment NPD
• University Emergency Medical Services Inc.

  • Emergency Medicine Physician
  • Buffalo, NY
  • NPI 1972540482
  Medicare reassignment
• Ub Family Medicine, Inc

  • Family Medicine Physician
  • Williamsville, NY
  • NPI 1942294467
  NPD
• Aesthetic Associates Centre Management LLC

  • Plastic Surgery Physician
  • Amherst, NY
  • NPI 1841143336
  NPD (past)
• Samuel Shatkin Jr MD PLLC

  • Ambulatory Surgical Clinic/Center
  • Amherst, NY
  • NPI 1841436995
  NPD (past)

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1841547239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 COMMUNITY WAY",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176032329",
            "telephone_number": "610-687-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 COMMUNITY WAY",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176032329",
            "telephone_number": "610-687-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYDE",
        "first_name": "ABBE",
        "middle_name": "MICHELE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-06",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018655",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0000831",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000024689",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABBE",
            "last_name": "JACKSON",
            "middle_name": "MICHELE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kerry Clements, CD
• Clinical Specialty Associates
• Emily M Clinton, CRNP
• Sarah Olivia Clisham
• Vanessa Clough, LAPC, ATR
• Corey Thompson Clyde, M.D.
• CMS Senior Care Inc
• Coatesville VA Medical Center
• Dara J. Cobb, CNIM
• Grace Ellen Cobian, D.C.

• Physician Assistant in Lancaster, PA
• Providers in Lancaster, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.