JACQUELINE EDDY (PA-C) – Surgical Physician Assistant, NPI 1972307148

JACQUELINE EDDY (PA-C) is a healthcare provider. based in East providence, Rhode Island. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA101655 (MA). The NPI Number for JACQUELINE EDDY (PA-C) is 1972307148

Main info

Organization
1 Year Of Experience
Accepts Medicare Assignment
Name
JACQUELINE EDDY (PA-C)
NPI
1972307148
Phone
Not provided
Address
1 KETTLE POINT AVE
Enumeration Date
4 April 2025
Last Update Date
22 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7813443535
Graduation Year
2025 (1 year ago)
PAC ID
9638695216
Group Practice PAC ID
7214185511
Professional Enrollment ID
I20250428000407
Address ID
MA023561000NO15XXXWAYX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

5,093 PHYSICIAN ASSISTANT in MA

Provider Addresses for JACQUELINE EDDY (PA-C)

  • 1 KETTLE POINT AVE

    EAST PROVIDENCE, RI 029145375

    Phone:

    Type: Mailing

  • 15 ROCHE BROS WAY STE 200

    NORTH EASTON, MA 023561000

    Phone: (781) 344-3535

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-04-28

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
I20250428000407IPhysician AssistantMATBD

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 02914)

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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: 7214185511View full group profile
NameSpecialtyState
-MA
Orthopedic SurgeryMA
Occupational Therapist In Private PracticeMA
Physical Medicine And RehabilitationMA
Hand Surgery, Orthopedic SurgeryMA
Physician AssistantMA
Orthopedic SurgeryMA
-MA
Anesthesiology, Pain ManagementMA
Physician AssistantMA

Reviews

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Frequently asked questions

Is there an official ID for JACQUELINE EDDY (PA-C) in U.S. healthcare records?
The official identifier for JACQUELINE EDDY (PA-C) is NPI 1972307148.
Active or inactive — what applies to JACQUELINE EDDY (PA-C)?
You should see JACQUELINE EDDY (PA-C) as active in CMS-hosted NPPES data.
What clinical focus is listed for JACQUELINE EDDY (PA-C)?
At a glance, JACQUELINE EDDY (PA-C) is tied to Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is JACQUELINE EDDY (PA-C) associated with East Providence?
Public fields place JACQUELINE EDDY (PA-C) around East Providence, Rhode Island. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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