CMS-1500 Box 24J / 33a • NPI
1265928964
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363A00000X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant
Box 32 Service Location & ZIP+4
160 RIVER BEND DR STE A, GRANITE FALLS, NC, 28630-9371
✓ 9-Digit EDI 837 ZIP+4 (28630-9371)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1265928964 (JESSICA BERRY CROUCH, PA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1265928964)
Medicare Beneficiaries
67
Total Billed Services
71
Distinct CPT/HCPCS Codes
4
Medicare Allowed Total
$3,693.04
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 63 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Amoxicillin Amoxicillin | 13 | 13 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 25 | 25 |
| Azithromycin Azithromycin | 16 | 16 |
| Cefdinir Cefdinir | 16 | 16 |
| Cephalexin Cephalexin | 13 | 13 |
| Doxycycline Hyclate Doxycycline Hyclate | 25 | 25 |
| Prednisone Prednisone | 35 | 34 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1265928964 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JESSICA BERRY CROUCH, PA |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant NUCC Code: 363A00000X (Physician Assistant) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 160 RIVER BEND DR STE A, GRANITE FALLS, NC, 28630-9371 |
| Practice Telephone / Fax | Tel: (828) 757-5060 | Fax: (828) 757-5064 |
| Administrative Mailing Address | 160 RIVER BEND DR STE A, GRANITE FALLS, NC, 28630-9371 |
| Enumeration & Last Sync | Enumerated: 2018-07-05 | CMS Record Updated: 2021-03-18 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363A00000X)
What Does Taxonomy Code 363A00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363A00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JESSICA BERRY CROUCH, PA)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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