Jacquelyn Peterson, - Medicare Physician Assistant in Jamestown, NY

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Jacquelyn Peterson, is a medicare enrolled "Physician Assistant - Medical" in Jamestown, New York. Her current practice location is 320 Prather Ave, Jamestown, New York. You can reach out to her office (for appointments etc.) via phone at (716) 753-7107.

Jacquelyn Peterson is licensed to practice in New York (license number 007012) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1124019948.

Contact Information

Jacquelyn Peterson,
320 Prather Ave,
Jamestown, NY 14701-6820
(716) 753-7107
Not Available

Map and Direction




Provider's Profile

Full NameJacquelyn Peterson
GenderFemale
SpecialityPhysician Assistant - Medical
Location320 Prather Ave, Jamestown, New York
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1124019948
  • Provider Enumeration Date: 11/01/2005
  • Last Update Date: 06/15/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 9133131071
  • Enrollment ID: I20060615000100

Medical Identifiers

Medical identifiers for Jacquelyn Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124019948NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical 007012 (New York)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jacquelyn Peterson allows following entities to bill medicare on her behalf.
Entity NameGreat Lakes Physician Practice PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1730599176
PECOS PAC ID: 6709007701
Enrollment ID: O20141016000108

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacquelyn Peterson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jacquelyn Peterson,
95 E Chautauqua St, Po Box 168,
Mayville, NY 14757-1017

Ph: Not Available		Jacquelyn Peterson,
320 Prather Ave,
Jamestown, NY 14701-6820

Ph: (716) 753-7107

Reviews and Comments


Physician Assistant Nurses in Jamestown, NY

Melissa Murphy,
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Phone: 270-485-7990    
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Phone: 716-708-6578    
Michael L Marsh, PA-C
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Practice Location: 207 Foote Ave, Jamestown, NY 14701
Phone: 716-664-8120    Fax: 716-664-8337
Paulette C Ziomek, PA
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Medicare: Medicare Enrolled
Practice Location: 207 Foote Ave, Jamestown, NY 14701
Phone: 716-487-0141    
Jesse Anderson,
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Practice Location: 207 Foote Ave, Jamestown, NY 14701
Phone: 716-664-8120    
Katie L Madden, PA-C
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Medicare: Accepting Medicare Assignments
Practice Location: 320 Prather Ave, Suite 100, 200, & 400, Jamestown, NY 14701
Phone: 716-338-0022    Fax: 716-338-1567
Mr. David B Smalling, RPA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 117 Foote Ave, Suite 100, Jamestown, NY 14701
Phone: 716-338-9200    Fax: 716-338-9250

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.