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JACLYN NICOLE CHURCHILL
NPI 1568695807
Physician Assistant in New York, NY

Active since September 03, 2009PECOS Enrolled
200 W 58TH ST, NEW YORK, NY 10019(212) 757-7010(212) 307-0759 Get Directions Write a Review

NPPES record last updated: February 2, 2023. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Feb 2, 2023, Apr 15, 2019 (2 updates tracked since 2019).

About Jaclyn Nicole Churchill NPPES

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

JACLYN NICOLE CHURCHILL (NPI 1568695807) is an individual physician assistant in New York, New York, licensed in Florida (PA 9104938) and active in the NPI registry since September 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1568695807
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameJACLYN NICOLE CHURCHILL
Location Address200 W 58TH STNew York, NY 10019-1476
Mailing Address200 W 58th StNew York, NY 10019-1476 · (212) 757-7010 · Fax (212) 307-0759
Phone(212) 757-7010
Fax(212) 307-0759
Sole ProprietorNo
Enumeration DateSeptember 3, 2009
Last NPPES UpdateFebruary 2, 20232 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2023
✔ NPI 1568695807 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 FL · PA 9104938
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.
200 W 58TH ST, New York, NY 10019
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jaclyn Nicole Churchill 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 10019 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
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
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.

Other Providers at the Same Location NPPES 4

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

DR. PINKAS E. LEBOVITS M.D.
Specialist
200 W 58TH ST
NEW YORK, NY 10019
New York County (212) 757-7010
MAREK PALIWODA RPA-C
Physician Assistant
200 W 58TH ST, SUITE 1E
NEW YORK, NY 10019
New York County (212) 757-7010
MR. LOUIS HAI LAM PA-C
Physician Assistant (Medical)
200 W 58TH ST
NEW YORK, NY 10019
New York County (212) 757-7010
PINKAS E.LEBOVITS, M.D., P.C.
Specialist
200 W 58TH ST
NEW YORK, NY 10019
New York County (212) 757-7010

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 Jaclyn Churchill's NPI number?

The NPI number for Jaclyn Churchill is 1568695807. It was assigned to this individual provider in the NPPES registry on September 3, 2009.

Where is Jaclyn Churchill located?

Jaclyn Churchill practices at 200 W 58th St, New York, NY 10019. The listed phone number is (212) 757-7010.

What is Jaclyn Churchill's specialty?

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

Is Jaclyn Churchill enrolled in Medicare?

Yes. Jaclyn Churchill is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jaclyn Churchill was last updated on February 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.