Individual provider Active NPI

Jennifer Allender, PA-C

  • Medical Physician Assistant
  • Moraine, OH
National Provider Identifier
1033624192
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50.005273RX Issued in OH
Practice address
3535 Kettering Blvd
Moraine, OH 45439-2014
Phone
(937) 395-6665
Fax
(937) 395-6668
NPI assigned
Dec 11, 2017
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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 50.005273RX OH
Medical Physician Assistant 363AM0700X 50.005273RX OH Primary

Addresses

Primary practice location

3535 Kettering Blvd
Moraine, OH 45439-2014

Mailing address

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-6665

Other identifiers 1

IdentifierTypeStateIssuer
0325536MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jallender574512@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180309000944 OH Practitioner - Physician Assistant 2365703295 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.005273RXOHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc CurrentSince Dec 17, 2018 Accepting new patients
Alliance Physicians Inc CurrentSince Dec 17, 2018 Accepting new patients

Locations

3359 Kemp Rd
Ste 240
Beavercreek, OH 45431
Phone (937) 429-7350

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

2115 Leiter Rd
Ste 300
Miamisburg, OH 45342

4000 Miamisburg Centerville Rd
Ste 450
Miamisburg, OH 45342
Phone (937) 439-3600

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Organizations & group practices 4

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1033624192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-6665",
            "fax_number": "937-395-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454392014",
            "telephone_number": "937-395-6665",
            "fax_number": "937-395-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLENDER",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-11",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005273RX",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.005273RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0325536",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jallender574512@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3535 Kettering Blvd",
            "city": "Moraine",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454392014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3535 Kettering Blvd",
            "city": "Moraine",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454392014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moraine, OH

Sources for this page

Verify at the official NPI Registry.