JADE LYNN HOLLEY (PAC) – Medical Physician Assistant, NPI 1134421183

JADE LYNN HOLLEY (PAC) is a healthcare provider. based in Moosic, Pennsylvania. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PAC. They hold a License No. MA054639 (PA). The NPI Number for JADE LYNN HOLLEY (PAC) is 1134421183

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
JADE LYNN HOLLEY (PAC)
NPI
1134421183
Phone
(570) 471-3569
Address
532 MAIN ST
Enumeration Date
24 November 2010
Last Update Date
3 January 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5702716144
Graduation Year
2010 (16 years ago)
PAC ID
6507085065
Group Practice PAC ID
5395657001
Professional Enrollment ID
I20150521000868
Address ID
PA178229800DA100XXAVEX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

9,691 PHYSICIAN ASSISTANT in PA

Provider Addresses for JADE LYNN HOLLEY (PAC)

  • 532 MAIN ST

    SUITE 1

    MOOSIC, PA 185071001

    Phone: (570) 471-3569

    Mailing address matches the actual address.

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 $25.

Total Amount is formed as General ($25) + Research ($0) + Ownership ($0) = $25.

Last reported payment date: 2024-05-10 • Largest payer in this snapshot: DePuy Synthes Sales Inc. ($25).

Total Amount

$25

General + Research + Ownership

Payments

1

Total payment records

General Amount

$25

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-10

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
DePuy Synthes Sales Inc.$25
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: 2015-05-21

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
I20150521000868IPhysician AssistantPATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes201104$0
99213Established patient office or other outpatient visit, 20-29 minutes7249$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report1111$0
View full utilization report →

Insurance plans in this area (ZIP 18507)

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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: 5395657001View full group profile

Reviews

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Frequently asked questions

What federal number belongs to JADE LYNN HOLLEY (PAC)?
The federal identifier for JADE LYNN HOLLEY (PAC) is NPI 1134421183.
Is JADE LYNN HOLLEY (PAC)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does JADE LYNN HOLLEY (PAC) treat or focus on?
Patients typically see JADE LYNN HOLLEY (PAC) under the specialty Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where does public data place JADE LYNN HOLLEY (PAC)?
The snapshot lists Moosic, Pennsylvania for JADE LYNN HOLLEY (PAC); download NPPES for the complete set.
Is JADE LYNN HOLLEY (PAC) a real provider?
This page reflects official NPPES data for NPI 1134421183. Always confirm identity and privileges with the practice and licensing boards.

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