Erin Olivia Jack, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

MA063004 Issued in PA

Practice address

2000 Oxford Dr
Bethel Park, PA 15102-1827

Phone

(412) 942-7880

NPI assigned

Dec 9, 2021

Last updated

Dec 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Clair Medical Services IncGroup PAC ID 4183511553, 203 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Clair Hospital Hospital, Pittsburgh, PA, CCN 390228

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Clair Medical Services, Inc.

  dba St. Clair Medical Group Psychiatry

  • Psychiatry Physician
  • Pittsburgh, PA
  • NPI 1467485565
  Medicare reassignment Care Compare group
• St Clair Medical Services Inc

  dba St. Clair Medical Group Otolaryngology

  • Otolaryngology Physician
  • Bethel Park, PA
  • NPI 1659224715
  NPD
• St. Clair Medical Services Inc.

  dba Popovich Internal Medicine

  • Family Medicine Physician
  • Bethel Park, PA
  • NPI 1881145282
  NPD
• St Clair Medical Services Inc

  dba St. Clair Medical Group Family Medicine

  • Family Medicine Physician
  • Bethel Park, PA
  • NPI 1447751979
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Clair Memorial Hospital

  dba St. Clair Hospital

  • General Acute Care Hospital
  • Pittsburgh, PA
  • NPI 1073587119
  Care Compare affiliation

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1902565781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 OXFORD DR",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151021827",
            "telephone_number": "412-942-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OXFORD DR",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151021827",
            "telephone_number": "412-942-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "ERIN",
        "middle_name": "OLIVIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA063004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia A Iampietro, RD, LDN
• Ideal Homecare Agency LLC
• Nicole Ilgenfritz, CRNP
• Jason Andrew Illig, COTA/L
• Inclusive Caregiving Agency LLC
• Bruce Michael Jacobs
• Gloria Annette James D'Alessandri, OTR, OTD
• Carmen Fred Jansante, PT, DPT
• Amy Marie Jennings, D.C.
• JJK Group, LLC (Senior Helpers of Southwest PA)

• Surgical Physician Assistant in Bethel Park, PA
• Providers in Bethel Park, PA by specialty
• Surgical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.