Michelle Jack, PA-C - Medicare Physician Assistant in Stony Brook, NY

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Michelle Jack, PA-C is a medicare enrolled "Physician Assistant" in Stony Brook, New York. She graduated from nursing school in 2016 and has 10 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Peconic Bay Primary Medical Care and her current practice location is Stony Brook Univ Hosp 101 Nicolls Road Hsc L-4 Rm050, Stony Brook, New York. You can reach out to her office (for appointments etc.) via phone at (631) 444-2478.

Michelle Jack is licensed to practice in New York (license number 020374) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1831631779.

Contact Information

Michelle Jack, PA-C
Stony Brook Univ Hosp 101 Nicolls Road Hsc L-4 Rm050,
Stony Brook, NY 11794-4927
(631) 444-2478
Not Available

Map and Direction




Provider's Profile

Full NameMichelle Jack
GenderFemale
SpecialityPhysician Assistant
Experience10 Years
LocationStony Brook Univ Hosp 101 Nicolls Road Hsc L-4 Rm050, Stony Brook, New York
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Michelle Jack graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1831631779
  • Provider Enumeration Date: 11/09/2016
  • Last Update Date: 06/27/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 9931483609
  • Enrollment ID: I20170223001723

Medical Identifiers

Medical identifiers for Michelle Jack such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1831631779NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 020374 (New York)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Peconic Bay Medical CenterRiverhead, NYHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Peconic Bay Primary Medical Care711381760272

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. Michelle Jack allows following entities to bill medicare on her behalf.
Entity NameCentral Suffolk Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043402050
PECOS PAC ID: 4981508082
Enrollment ID: O20031120000840
Entity NamePeconic Bay Primary Medical Care
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487620613
PECOS PAC ID: 7113817602
Enrollment ID: O20040318000260
Entity NameNorth Shore-lij Medical PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053688572
PECOS PAC ID: 3375701568
Enrollment ID: O20120220000262
Entity NameProgressive Emergency Physicians PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1588098172
PECOS PAC ID: 8820225956
Enrollment ID: O20131218000289

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. Michelle Jack 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
Michelle Jack, PA-C
Po Box 1559,
Stony Brook, NY 11790-0989

Ph: (631) 444-2478		Michelle Jack, PA-C
Stony Brook Univ Hosp 101 Nicolls Road Hsc L-4 Rm050,
Stony Brook, NY 11794-4927

Ph: (631) 444-2478

Reviews and Comments


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Bridget A. Nozdrovicky, P.A.
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Medicare: Accepting Medicare Assignments
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Michael Scott Weber, RPA-C
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Phone: 631-751-3322    Fax: 631-751-3844

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.