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

Jillian Marie Wickham, PA

Individual provider Medical Physician Assistant · NPI 1740929579

Jillian Marie Wickham, PA is a Physician Assistant in New York, New York. Qualified in 2022, 4 years ago. Practices with Icahn School of Medicine at Mount Sinai, a 2,791-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2022
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

325 W 15th St
New York, NY 10011-5903
Phone: (212) 604-6000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1740929579
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 31, 2022
Last updated in NPPESMay 31, 2022
Certification dateMay 31, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Icahn School Of Medicine At Mount Sinai — 2791 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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