Individual provider Active NPI

Jennifer K Stern, PA-C

  • Medical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1053647909
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4542 Issued in AZ
Practice address
9250 N 3Rd St
Suite 3000
Phoenix, AZ 85020-2437
Phone
(602) 633-3710
Fax
(602) 633-3711
NPI assigned
Oct 28, 2009
Last updated
Oct 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4542 AZ Primary
Surgical Physician Assistant 363AS0400X AZ

Addresses

Primary practice location

9250 N 3Rd St
Suite 3000
Phoenix, AZ 85020-2437

Mailing address

3237 N Windsong Dr
Prescott Valley, AZ 86314-1222
Phone (928) 772-5320

Other identifiers 1

IdentifierTypeStateIssuer
506790MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20100527000694 AZ Practitioner - Physician Assistant 3072642149 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Davis OrthopaedicsGroup PAC ID 0749506269, 7 clinicians

Practice addresses (Care Compare)

3221 N Windsong Dr
Prescott Valley, AZ 86314-1222
Phone (928) 910-7010

3237 N Windsong Dr
Prescott Valley, AZ 86314-1222
Phone (928) 772-5320

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4542AZMDChild Mental Illness Respite Care

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Sports Medicine LLC CurrentSince Oct 13, 2021 Accepting new patients
Modern Sports Medicine LLC CurrentSince Oct 13, 2021 Accepting new patients
Davis Orthopaedics, LLC Past Accepting new patients
Privia Medical Group Arizona, LLC Past Accepting new patients

Locations

100 S McClintock Dr
Ste 100
Chandler, AZ 85226
Phone (480) 633-3388

5590 W Chandler Blvd
Ste 4
Chandler, AZ 85226
Phone (480) 786-4969

10450 E Riggs Rd
Ste 104
Sun Lakes, AZ 85248
Phone (612) 888-5224

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CGGJCA/Endpoint/CGGJCA

Organizations & group practices 6

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": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1053647909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3237 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141222",
            "telephone_number": "928-772-5320",
            "fax_number": "928-772-5319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 N 3RD ST",
            "address_2": "SUITE 3000",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202437",
            "telephone_number": "602-633-3710",
            "fax_number": "602-633-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4542",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506790",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.