JACQUELINE WOODBURN PA
NPI 1710780028
Physician Assistant in East Patchogue, NY
About Jacqueline Woodburn Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACQUELINE WOODBURN PA (NPI 1710780028) is an individual physician assistant in East Patchogue, New York, licensed in New York (033652) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jacqueline Woodburn Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11772 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PATCHOGUE, NY 11772
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 Jacqueline Woodburn's NPI number?
The NPI number for Jacqueline Woodburn is 1710780028. It was assigned to this individual provider in the NPPES registry on March 31, 2025.
Where is Jacqueline Woodburn located?
Jacqueline Woodburn practices at 129 Sunrise Hwy W, East Patchogue, NY 11772. The listed phone number is (631) 230-5774.
What is Jacqueline Woodburn's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Jacqueline Woodburn enrolled in Medicare?
Yes. Jacqueline Woodburn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Jacqueline Woodburn was last updated on March 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.
# Jacqueline Woodburn, PA · NPI 1710780028
Physician Assistant physician in East Patchogue, New York. Individual provider, active in the CMS NPPES registry since March 31, 2025.
## Identity
- **NPI:** 1710780028 (Entity type: Individual)
- **Enumerated:** March 31, 2025
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** 033652 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 129 SUNRISE HWY W, East Patchogue, NY 11772-1846
- **Phone:** (631) 230-5774
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** March 31, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1710780028) · Data from the CMS NPPES public registry.