Individual provider Active NPI

Jasie Behrens, PA

  • Physician Assistant
  • Lakeland, FL
National Provider Identifier
1003481680
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9114380 Issued in FL
Practice address
1755 N Florida Ave
Lakeland, FL 33805-3109
Phone
(863) 904-6201
Fax
(866) 264-8519
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9114380 FL Primary
Physician Assistant 363A00000X 9114380 FL

Addresses

Primary practice location

1755 N Florida Ave
Lakeland, FL 33805-3109

Mailing address

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbehrens20039@direct.watsonclinicad.com Watson Clinic LLP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210624002800 FL Practitioner - Physician Assistant 4486055647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watson Clinic LLPGroup PAC ID 1456258979, 365 clinicians

Practice addresses (Care Compare)

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000

1755 N Florida Ave
Lakeland, FL 33805-3109
Phone (863) 904-6200

Merit-based Incentive Payment System (MIPS)

Final score
87.18 of 100Reported as apm
Quality
70.68
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9114380FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Watson Clinic LLP CurrentSince Jun 28, 2021 Accepting new patients
Watson Clinic LLP Current Accepting new patients

Locations

1600 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7190

1755 N Florida Ave
Lakeland, FL 33805
Phone (863) 904-6200

1430 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7337

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1003481680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053019",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 N FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053109",
            "telephone_number": "863-904-6201",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHRENS",
        "first_name": "JASIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114380",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9114380",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbehrens20039@direct.watsonclinicad.com",
            "affiliation": "Y",
            "endpointDescription": "Direct Messaging Address",
            "affiliationName": "Watson Clinic LLP",
            "address_1": "1430 Lakeland Hills Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338053202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.