Individual provider Active NPI

Jackson Brown, PA-C

  • Surgical Physician Assistant
  • Beachwood, OH
National Provider Identifier
1912612607
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.007912RX Issued in OH
Practice address
3999 Richmond Rd
Beachwood, OH 44122-6046
Phone
(216) 293-8226
NPI assigned
Jan 18, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50.007912RX OH Primary

Addresses

Primary practice location

3999 Richmond Rd
Beachwood, OH 44122-6046

Mailing address

7180 Walton Rd
Walton Hills, OH 44146-4359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230225000085 OH Practitioner - Physician Assistant 8224401013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

1000 Auburn Dr
Beachwood, OH 44122-4317
Phone (216) 285-5028

11100 Euclid Ave
Cleveland, OH 44106-1716

3999 Richmond Rd
Beachwood, OH 44122-6046
Phone (216) 593-5500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.007912RXOHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc CurrentSince Feb 1, 2023 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

3999 Richmond Rd
Ste 2700
Beachwood, OH 44122

1000 Auburn Dr
Ste 210
Beachwood, OH 44122
Phone (440) 743-8139

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

3999 Richmond Rd
Cleveland, OH 44122
Phone (216) 293-8226

11100 Euclid Ave
Cleveland Heights, OH 44106

7500 Auburn Rd
Ste 2500
Concord Township, OH 44077
Phone (216) 290-3234

7580 Auburn Rd
Ste 214
Concord Township, OH 44077
Phone (216) 896-0351

9000 Mentor Ave
Ste 209
Mentor, OH 44060
Phone (440) 516-8700

8819 Commons Blvd
Ste 101
Twinsburg, OH 44087
Phone (330) 405-1500

Interoperability endpoints

  • Direct secure messaging: jbrown112750@ehrdirect.uhhospitals.org

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1912612607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7180 WALTON RD",
            "city": "WALTON HILLS",
            "state": "OH",
            "postal_code": "441464359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 RICHMOND RD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441226046",
            "telephone_number": "216-293-8226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACKSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.007912RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.