Jacqueline Woodburn, PA
NPI 1710780028ActiveIndividual· Physician Assistant· East Patchogue, NY
Physician Assistant (PA) with City Medical of Upper East Side PLLC, practicing in East Patchogue, New York. Enrolled in Medicare as practitioner - physician assistant.
Overview
| NPI | 1710780028 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA |
| Sole proprietor | Yes |
| NPI issued | Mar 31, 2025 |
| Last updated in NPPES | Mar 31, 2025 |
| Certified by provider | Mar 31, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 033652 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (NY) |
|---|
Education and affiliations
| Graduation year | 2025 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- City Medical of Upper East Side PLLCAstoria, NY · 658 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 19 physician assistants in East Patchogue · All physician assistants in New York