Individual provider Active NPI

Jason Lincoln, PA-C

  • Physician Assistant
  • Charles Town, WV
National Provider Identifier
1881929834
Registry record updated Oct 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
01423 Issued in WV
Practice address
84 Somerset Blvd
Charles Town, WV 25414-4827
Phone
(304) 728-8533
NPI assigned
Oct 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2009

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 01423 WV Primary

Addresses

Primary practice location

84 Somerset Blvd
Charles Town, WV 25414-4827

Mailing address

84 Somerset Blvd
Charles Town, WV 25414-4827
Phone (304) 728-8533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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

Enrollment IDStateProvider typePAC IDDetails
I20110610000270 MD Practitioner - Physician Assistant 1355528878 Reassigns benefits to 3 organizations
I20110610000459 DC Practitioner - Physician Assistant 1355528878 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Western Maryland Health Services, LLC CurrentSince Jan 1, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

12501 Willowbrook Rd
Fl 3
Cumberland, MD 21502
Phone (240) 964-8515

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254960000000",
    "number": "1881929834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 SOMERSET BLVD",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254144827",
            "telephone_number": "304-728-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 SOMERSET BLVD",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254144827",
            "telephone_number": "304-728-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINCOLN",
        "first_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-08",
        "last_updated": "2009-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charles Town, WV

Sources for this page

Verify at the official NPI Registry.