MS. JESSICA LYSTER PA-C
NPI 1912639436
Physician Assistant in Athens, GA

Q: What is Jessica Lyster's NPI number?

The NPI number for Jessica Lyster is 1912639436. It was assigned to this individual provider in the NPPES registry on June 24, 2022.

Q: What is Jessica Lyster'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 Jessica Lyster was last updated on January 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since June 24, 2022PECOS EnrolledAccepts Medicare Assignment

1765 OLD WEST BROAD ST, ATHENS, GA 30606(706) 549-1663(706) 286-7426 Get Directions Write a Review

NPPES record last updated: January 22, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jan 22, 2026, Nov 11, 2024 (2 updates tracked since 2024).

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About Ms. Jessica Lyster Pa-c NPPES

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

MS. JESSICA LYSTER PA-C (NPI 1912639436) is an individual physician assistant in Athens, Georgia, licensed in Georgia (12669) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS, is affiliated with St. Mary's Good Samaritan Hospital, and maintains a secondary practice location in Loganville.

NPPES Registry Identity

NPI1912639436

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMS. JESSICA LYSTERCredential: PA-C

Location Address1765 OLD WEST BROAD STAthens, GA 30606-2853

Mailing Address1765 Old West Broad St Bldg 2-200Athens, GA 30606-2887 · (706) 549-1663 · Fax (706) 546-8792

Phone(706) 549-1663

Fax(706) 286-7426

Sole ProprietorNo

Medical School CMSMorehouse School Of MedicineGraduated 2024

Enumeration DateJune 24, 2022

Last NPPES UpdateJanuary 22, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 22, 2026

✔ NPI 1912639436 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 GA · 12669

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.

1765 OLD WEST BROAD ST, Athens, GA 30606

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Secondary Practice Location 1

Location 13440 Highway 81Loganville, GA 30052-9112 · Phone (770) 554-5009 · Fax (706) 546-8792

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

Ms. Jessica Lyster Pa-c 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.

PECOS PAC ID2961922976

PECOS Enrollment IDI20250220003217

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St. Mary's Good Samaritan Hospital

Critical Access Hospitals · Greensboro, GA

4/5 CMS rating

OwnershipProprietary

CMS Certification Number111329

Location5401 Lake Oconee ParkwayGreensboro, GA 30642 · Greene County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30606 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$66.89 typical visit price

range $16.68 – $133.24

Typical copayment $16.72 (range $4.17 – $33.31)

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 20

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

JOSEPH HALE PA-C

Physician Assistant