Individual provider Active NPI

Jacinta Rebekah Jolly, PA-C

  • Medical Physician Assistant
  • Greensburg, PA
National Provider Identifier
1932944741
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
532 W Pittsburgh St
Greensburg, PA 15601-2239
Phone
(724) 832-4626
NPI assigned
Jun 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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 Primary

Addresses

Primary practice location

532 W Pittsburgh St
Greensburg, PA 15601-2239

Mailing address

532 W Pittsburgh St
Greensburg, PA 15601-2239
Phone (724) 832-4626

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
I20250521003124 PA Practitioner - Physician Assistant 9830618917 Reassigns benefits to 1 organization

National Provider Directory

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

Organizations & group practices 1

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": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1932944741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 W PITTSBURGH ST",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156012239",
            "telephone_number": "724-832-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 W PITTSBURGH ST",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156012239",
            "telephone_number": "724-832-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "JACINTA",
        "middle_name": "REBEKAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

Verify at the official NPI Registry.