NPIMap

Individual provider Active NPI

Jardena Garner, PA

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1073561072
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21422 Issued in CA
Practice address
200 W Arbor Dr
Ucsd Medical Center - Department of Orthopedics
San Diego, CA 92103-9000
Phone
(619) 543-2539
Fax
(619) 543-2540
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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 008989 NY
Physician Assistant 363A00000X PA21422 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
Ucsd Medical Center - Department of Orthopedics
San Diego, CA 92103-9000

Mailing address

200 W Arbor Dr
Ucsd Medical Center - Department of Orthopedics
San Diego, CA 92103-9000
Phone (619) 543-2539

Other identifiers 1

IdentifierTypeStateIssuer
02331244MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110922000636 CA Practitioner - Physician Assistant 5597821942 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21422CAMDClinical Social Worker
008989NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Oct 30, 2014 Accepting new patients
Regents of the University of California CurrentSince Aug 7, 2011 Accepting new patients
Regents of the University of California CurrentSince Aug 7, 2011 Accepting new patients
LH Emergency Medical Services PC Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
Park Lenox Emergency Medicine, PC Past Accepting new patients
UCSF Medical Group Business Services Past Accepting new patients
University of California San Francisco Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 9

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1073561072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "UCSD MEDICAL CENTER - DEPARTMENT OF ORTHOPEDICS",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-2539",
            "fax_number": "619-543-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "UCSD MEDICAL CENTER - DEPARTMENT OF ORTHOPEDICS",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-2539",
            "fax_number": "619-543-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARNER",
        "first_name": "JARDENA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008989",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02331244",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.