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JESSE J KIBERT PA
NPI 1104072388
Physician Assistant - Medical in Canton, NY

Active since August 07, 2008
4 COMMERCE LANE, CANTON, NY 13617(315) 386-8191(315) 386-1410 Get Directions Write a Review

NPPES record last updated: July 6, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jesse J Kibert Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSE J KIBERT PA (NPI 1104072388) is an individual medical provider in Canton, New York, licensed in New York (014002) and active in the NPI registry since August 2008.

NPPES Registry Identity

NPI1104072388
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameJESSE J KIBERTCredential: PA
Location Address4 COMMERCE LANECanton, NY 13617-3739
Mailing Address4 Commerce Lane, P.o. Box 407Canton, NY 13617-3739 · (315) 386-8191 · Fax (315) 386-1410
Phone(315) 386-8191
Fax(315) 386-1410
Sole ProprietorNo
Enumeration DateAugust 7, 2008
Last NPPES UpdateJuly 6, 2011
✔ NPI 1104072388 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NY · 014002
4 COMMERCE LANE, Canton, NY 13617
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Other Identifiers 6

Medicare PIN110809KS
Other110809KS · Blue Cross/blue Shield Group
Medicare OSCAR/certification178968KS
Medicaid100427890BKS
Medicare PINAA0564NY
Medicaid01995615NY

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. BARBARA L TERIELE LPN
Licensed Practical Nurse
4 COMMERCE LANE
CANTON, NY 13617
St. Lawrence County (315) 386-8191
ERIN BETH KNOWLTON RN
Registered Nurse
4 COMMERCE LANE
CANTON, NY 13617
St. Lawrence County (315) 386-8191
ANDREW FOX WILLIAMS MD
Internal Medicine
4 COMMERCE LANE
CANTON, NY 13617
St. Lawrence County (315) 386-8191
MUHAMMAD U SALEEM M.D.
Psychiatry & Neurology (Psychiatry)
4 COMMERCE LANE
CANTON, NY 13617
St. Lawrence County (315) 386-8191
MISS TAMAR A. HAMILTON PHYSICAL THERAPIST
Physical Therapist
4 COMMERCE LANE, CPA OF THE NORTH COUNTY
CANTON, NY 13617
St. Lawrence County (315) 386-8191
DEBORAH G NINA DDS
Dentist
4 COMMERCE LANE
CANTON, NY 13617
St. Lawrence County (315) 386-8791
MRS. VIRGINIA MARIE DEROUCHIE RDH
Dental Hygienist
4 COMMERCE LANE
CANTON, NY 13617
St. Lawrence County (315) 386-8191
KENNETH HENRY HILBORNE JR. NP
Nurse Practitioner
4 COMMERCE LANE
CANTON, NY 13617
St. Lawrence County (315) 386-8191

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jesse Kibert's NPI number?

The NPI number for Jesse Kibert is 1104072388. It was assigned to this individual provider in the NPPES registry on August 7, 2008.

Where is Jesse Kibert located?

Jesse Kibert practices at 4 Commerce Lane, Canton, NY 13617. The listed phone number is (315) 386-8191.

What is Jesse Kibert's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Jesse Kibert was last updated on July 6, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.