Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacqueline Rose Thaw

Individual provider Physician Assistant · NPI 1063396661

Jacqueline Rose Thaw is a Physician Assistant in West Islip, New York. Qualified in 2025, 1 year ago. Practices with St Joseph Hospital, a 99-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2025

Practice location Address checks out

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone: (631) 376-3000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 034153 (NY)

Record details

NPI number1063396661
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorYes
NPI enumeratedAugust 5, 2025
Last updated in NPPESAugust 5, 2025
Certification dateAugust 5, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice St. Joseph Hospital — 99 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in West Islip