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

Jill J Weatherly, PA

Individual provider Physician Assistant · NPI 1497158158

Jill J Weatherly, PA is a Physician Assistant in Syracuse, New York. Qualified in 2014, 12 years ago. Practices with Upstate Community Medical, PC, a 152-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
12
Licensed in
NY
In the registry since
2014
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

4900 Broad Rd Ofc
Syracuse, NY 13215-2265
Phone: (315) 464-8525
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 018134 (NY)

Record details

NPI number1497158158
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 8, 2014
Last updated in NPPESOctober 8, 2014

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Upstate Community Medical, Pc — 152 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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