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MRS. LAURA RAE JACKAM P.A.
NPI 1922711993
Physician Assistant in Medina, OH

Active since January 04, 2023PECOS EnrolledAccepts Medicare Assignment
4975 FOOTE RD., STE. #400, MEDINA, OH 44256(330) 591-9038(330) 722-8585 Get Directions Write a Review

NPPES record last updated: October 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 6, 2024, Jan 4, 2023 (2 updates tracked since 2023).

About Mrs. Laura Rae Jackam P.a. NPPES

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

MRS. LAURA RAE JACKAM P.A. (NPI 1922711993) is an individual physician assistant in Medina, Ohio, licensed in Ohio (50.008854RX) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1922711993
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. LAURA RAE JACKAMCredential: P.A.
Location Address4975 FOOTE RD., STE. #400Medina, OH 44256-9048
Mailing Address2000 Auburn Dr., Ste. 350Beachwood, OH 44122-4327 · (440) 646-1600 · Fax (440) 646-1505
Phone(330) 591-9038
Fax(330) 722-8585
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJanuary 4, 2023
Last NPPES UpdateOctober 21, 20252 updates tracked since enumeration
NPPES CertifiedOctober 21, 2025
✔ NPI 1922711993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in OH · 50.008854RX
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
4975 FOOTE RD., Medina, OH 44256
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Other Identifiers 1

Medicaid0081746OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual and more.Insurance ›

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

Mrs. Laura Rae Jackam P.a. 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 ID7517499445
PECOS Enrollment IDI20241017000366
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 44256 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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.

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 Laura Jackam's NPI number?

The NPI number for Laura Jackam is 1922711993. It was assigned to this individual provider in the NPPES registry on January 4, 2023.

Where is Laura Jackam located?

Laura Jackam practices at 4975 Foote Rd. Ste. #400, Medina, OH 44256. The listed phone number is (330) 591-9038.

What is Laura Jackam's specialty?

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

Is Laura Jackam enrolled in Medicare?

Yes. Laura Jackam 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.

What insurance does Laura Jackam accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, MedMutual, Oscar Insurance Corporation of Ohio and SummaCare list Laura Jackam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Laura Jackam was last updated on October 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.