| Olivia Jackson, | |
|
570 Lexington Ave Fl 9, New York, NY 10022-6710 | |
| (164) 696-2727 | |
| Not Available |
| Full Name | Olivia Jackson |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 5 Years |
| Location | 570 Lexington Ave Fl 9, New York, New York |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154944791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 12941328-1206 (Utah) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Intermountain Health Intermountain Medical Center | Murray, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Vitalcare Health Services Pc | 2264961861 | 46 |
| Vitalcare Health Services Pc | 2264961861 | 46 |
| Ihc Health Services Inc | 1850209420 | 3948 |
| Entity Name | Ihc Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629260880 PECOS PAC ID: 1850209420 Enrollment ID: O20031105000079 |
| Entity Name | Vitalcare Health Services PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235954389 PECOS PAC ID: 2264961861 Enrollment ID: O20250128001818 |
| Mailing Address | Practice Location Address |
|---|---|
| Olivia Jackson, 570 Lexington Ave Fl 9, New York, NY 10022-6710 Ph: (164) 696-2727 | Olivia Jackson, 570 Lexington Ave Fl 9, New York, NY 10022-6710 Ph: (164) 696-2727 |
Mr. Martin Haynes Nicol Sr., PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2367-69 2nd Ave, New York, NY 10035 Phone: 212-876-2300 Fax: 212-369-8209 |
Mrs. Rachel T. Freeman, RPA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 160 E 53rd St, 3rd Floor, New York, NY 10022 Phone: 212-610-0067 |
Geraldine Deguzman-javier, RPAC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 16th St. And 1st Ave., New York, NY 10003 Phone: 212-420-2121 |
Allison C. Santhouse, RPA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 115 E 57th St, Suite 710, New York, NY 10022 Phone: 212-750-8900 Fax: 908-281-7796 |
Sarah E. Mccord, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 535 E 70th St, New York, NY 10021 Phone: 212-606-1585 Fax: 917-260-3185 |
Miss Sharona Deborah Kashimallak, RPA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 462 1st Ave, New York, NY 10016 Phone: 516-578-9951 |
Rena Dymersky, RPA-C, MS Physician Assistant Medicare: Medicare Enrolled Practice Location: 1 Gustave L Levy Pl, New York, NY 10029 Phone: 212-241-6500 |