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

Jacqueline Woodburn, PA

Individual provider Physician Assistant · NPI 1710780028

Jacqueline Woodburn, PA is a Physician Assistant in East Patchogue, New York. Qualified in 2025, 1 year ago. Practices with City Medical of Upper East Side PLLC, a 663-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2025
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

129 Sunrise Hwy W
East Patchogue, NY 11772-1846
Phone: (631) 230-5774
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 033652 (NY)

Record details

NPI number1710780028
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedMarch 31, 2025
Last updated in NPPESMarch 31, 2025
Certification dateMarch 31, 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 City Medical Of Upper East Side Pllc — 663 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations10 on file with Medicare

Other providers in East Patchogue