Active NPI
Jennifer J. Judelson, PA-C
- Physician Assistant
- Orange, CA
National Provider Identifier
1053477216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA18791
- Practice address
- 1140 W la Veta Ave
Suite 860
Orange, CA 92868-4225 - Phone
- (714) 835-6500
- Fax
- (714) 541-6105
- NPI assigned
- Dec 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA18791 | CA | Primary |
Addresses
Primary practice location
1140 W la Veta Ave
Suite 860
Orange, CA 92868-4225
Mailing address
1140 W la Veta Ave
Suite 860
Orange, CA 92868-4225
Phone (714) 835-6500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7300 SW Childs Rd
Suite B
Tigard, OR 97224-7772
Phone (503) 692-8700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oregon Sports Medicine Associates | Past | Accepting new patients |
Organizations & group practices 1
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": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307491200000",
"number": "1053477216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1140 W LA VETA AVE",
"address_2": "SUITE 860",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684225",
"telephone_number": "714-835-6500",
"fax_number": "714-541-6105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 W LA VETA AVE",
"address_2": "SUITE 860",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684225",
"telephone_number": "714-835-6500",
"fax_number": "714-541-6105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDELSON",
"first_name": "JENNIFER",
"middle_name": "J.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-29",
"last_updated": "2011-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA18791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.