Individual provider Active NPI

Jessica Dipietro, PA-C

  • Medical Physician Assistant
  • Charleston, SC
National Provider Identifier
1881025575
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA056602 Issued in PA
Practice address
316 Calhoun St
Charleston, SC 29401
Phone
(843) 724-2010
Fax
(843) 724-1953
NPI assigned
Dec 5, 2013
Last updated
Feb 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA056602 PA Primary

Addresses

Primary practice location

316 Calhoun St
Charleston, SC 29401

Mailing address

PO Box 601495
Charlotte, NC 28260-1495
Phone (843) 789-1620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20140318000400 PA Practitioner - Physician Assistant 8224269121 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.3 of 100Reported as group
Quality
81.65
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.36 of 100Reported as group
Quality
79.93
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2147SCMDOptometrist
MA056602PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nason Medical Center V, LLC Past Accepting new patients
Nason Medical Center IV, LLC Past Accepting new patients

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1386201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1881025575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601495",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601495",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 CALHOUN ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29401",
            "telephone_number": "843-724-2010",
            "fax_number": "843-724-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPIETRO",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-05",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA056602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.