VICTOR JACKSON PA-C
NPI 1568644185
Physician Assistant in Coudersport, PA

Q: What is Victor Jackson's NPI number?

The NPI number for Victor Jackson is 1568644185. It was assigned to this individual provider in the NPPES registry on December 5, 2007.

Q: What is Victor Jackson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Victor Jackson was last updated on August 27, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 05, 2007PECOS Enrolled

1001 E 2ND ST, COUDERSPORT, PA 16915(814) 274-9300 Get Directions Write a Review

NPPES record last updated: August 27, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Victor Jackson Pa-c NPPES

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

VICTOR JACKSON PA-C (NPI 1568644185) is an individual physician assistant in Coudersport, Pennsylvania, licensed in Pennsylvania (MA052972) and active in the NPI registry since December 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1568644185

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameVICTOR JACKSONCredential: PA-C

Location Address1001 E 2ND STCoudersport, PA 16915-8161

Mailing Address1001 E 2nd StCoudersport, PA 16915-8161 · (814) 274-9300

Phone(814) 274-9300

Sole ProprietorNo

Enumeration DateDecember 5, 2007

Last NPPES UpdateAugust 27, 2009

✔ NPI 1568644185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in PA · MA052972

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1001 E 2ND ST, Coudersport, PA 16915

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Other Identifiers 1

Medicare PIN148847JT3PA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Victor Jackson Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16915 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

Established Patient

$68.36 typical visit price

range $17.33 – $135.84

Typical copayment $17.09 (range $4.33 – $33.96)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier21 claims21 services$3.96 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers17 claims17 services$102.49 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$38.23 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$38.16 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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. MELISSA LYN O'BRIEN A.T.C.

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