Jacqueline Cain, DO
Individual provider Active NPI Internal Medicine Physician · Kingston, PA
NPI 1891708533 · NPPES record last updated Jul 26, 2021
Key facts
- NPI
- 1891708533
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- OS006939L (PA)
- Practice address
- 610 Wyoming Ave
Suite 2
Kingston, PA 18704-3702 - Phone
- (570) 288-6627
- Fax
- (570) 288-6699
- NPI assigned
- Aug 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 53
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Philadelphia College of Osteopathic Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Phoenix Rehabilitation and Health Services Inc
Commonwealth Physician Network LLC
Practice addresses (Care Compare)
2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238
4 E Main St
Nanticoke, PA 18634-1602
Phone (570) 735-7474
610 Wyoming Ave
Kingston, PA 18704-3702
Phone (570) 288-5441
Hospital & facility affiliations
- Bayada Home Health Care, Inc.
- Associated Family Home Care, Inc.
- Aveanna Home Health
- Wilkes-Barre General Hospital
- Geisinger Wyoming Valley Medical Center
- Geisinger Medical Center
- John Heinz Institute of Rehabilitation Medicine
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.17 of 100
- Quality
- 78.34
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091221000479 | PA | Practitioner - Internal Medicine | 7113099425 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS006939L | PA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth Physician Network LLC | Internal Medicine | Current |
Accepting new patients |
Locations
610 Wyoming Ave
Kingston, PA 18704
Phone (570) 288-5441
610 Wyoming Ave
#2
Kingston, PA 18704
Phone (570) 714-1032
4 E Main St
Nanticoke, PA 18634
Phone (570) 258-3939
Interoperability endpoints
- jacqueline.cain.1@21771.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | OS006939L | PA | Yes |
Addresses
Primary practice location
610 Wyoming Ave
Suite 2
Kingston, PA 18704-3702
Mailing address
610 Wyoming Ave
Kingston, PA 18704-3702
Phone (570) 288-5441
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001232233 | Medicaid | PA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jacqueline.cain.1@21771.direct.athenahealth.com |
Other providers in Kingston, PA
- Victoria Michelle Burris
- Marian Catherine Lynch Byrnes
- C. N. Burns, Jr., M.D.
- C2 Counseling Group LLC
- Maura Cadwalader
- Cassie Marie Caldwell
- Crescenzo Guilio Calise
- Callahan and Bergey Associates P.C.
- Michael Dennis Callahan
- Joseph Anthony Campanella
All providers in Kingston, PA · Internal Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.