JESSICA MCWATTERS (PAC) – Physician Assistant, NPI 1124889852

JESSICA MCWATTERS (PAC) is a healthcare provider. based in Grand rapids, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PAC. They hold a License No. 5601012120 (MI). The NPI Number for JESSICA MCWATTERS (PAC) is 1124889852

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA MCWATTERS (PAC)
NPI
1124889852
Phone
Not provided
Address
100 MICHIGAN ST NE # MC845
Enumeration Date
19 January 2024
Last Update Date
8 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2319244200
Graduation Year
2023 (3 years ago)
PAC ID
4981040680
Group Practice PAC ID
4880503051
Professional Enrollment ID
I20240315000822
Address ID
MI494121526FR230XXSTXX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

6,066 PHYSICIAN ASSISTANT in MI

Provider Addresses for JESSICA MCWATTERS (PAC)

  • 100 MICHIGAN ST NE # MC845

    GRAND RAPIDS, MI 495032560

    Phone:

    Type: Mailing

  • 230 W OAK ST

    FREMONT, MI 494121526

    Phone: (231) 924-4200

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $22.

Total Amount is formed as General ($22) + Research ($0) + Ownership ($0) = $22.

Last reported payment date: 2024-11-07 • Largest payer in this snapshot: HeartFlow, Inc. ($22).

Total Amount

$22

General + Research + Ownership

Payments

1

Total payment records

General Amount

$22

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-07

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
HeartFlow, Inc.$22
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-03-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240315000822IPhysician AssistantMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49503)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4880503051View full group profile
NameSpecialtyState
Orthopedic SurgeryMI
Family Practice, Obstetrics/GynecologyMI
Cardiovascular Disease (Cardiology)MI
Nurse PractitionerMI
-MI
U R O L O G YMI
Nurse PractitionerMI
Nurse PractitionerMI
Certified Nurse Midwife (Cnm)MI
Internal Medicine, Pediatric MedicineMI

Reviews

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Frequently asked questions

Can I cross-check JESSICA MCWATTERS (PAC) using NPI 1124889852?
NPI 1124889852 belongs to JESSICA MCWATTERS (PAC); compare other details if you need extra assurance.
Is JESSICA MCWATTERS (PAC) still an active registrant?
JESSICA MCWATTERS (PAC) carries an active NPI according to the public dataset.
What kind of doctor is JESSICA MCWATTERS (PAC)?
JESSICA MCWATTERS (PAC) is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with JESSICA MCWATTERS (PAC)?
Directory geography for JESSICA MCWATTERS (PAC) centers on Grand Rapids, Michigan.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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