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Michelle Jack, PA-C

NPI 1831631779ActiveIndividual· Physician Assistant· Stony Brook, NY

Physician Assistant (PA-C) with Peconic Bay Primary Medical Care, practicing in Stony Brook, New York. 51 Medicare patients in 2024, $7,699 paid; nearly all of their 91 Part D prescriptions were generic (99%). Lists Peconic Bay Medical Center as a hospital affiliation.

Overview

NPI1831631779
StatusActive
Entity typeIndividual
CredentialPA-C
Sole proprietorNo
NPI issuedNov 9, 2016
Last updated in NPPESJun 27, 2019

Specialties and licenses

TaxonomyCodeLicenseState
Physician Assistant Primary363A00000X020374NY

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Physician Assistant (NY)
Accepts assignmentYes (participating)

Medicare services in 2024

Medicare patients51
Services billed126 across 20 procedure codes
Paid by Medicare$7,699

Part D prescriptions in 2024

Prescriptions (claims)91 · 91 30-day fills
Patients52
Total drug cost$278.97
Generic share99% of claims

Medicare sources and data years

Education and affiliations

Graduation year2016
Medicare specialtyPhysician Assistant

Medical group

Hospital affiliation

Source: CMS Care Compare

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other physician assistants in Stony Brook

All 130 physician assistants in Stony Brook · All physician assistants in New York