Jenifer Kay Fortney, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10002104A Issued in IN

Practice address

5650 Coventry LN
Fort Wayne, IN 46804-7140

Phone

(217) 508-8478

NPI assigned

Jun 16, 2016

Last updated

Dec 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Three Rivers Dermatology, LLCGroup PAC ID 3375685092, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Noble Hospital Hospital, Kendallville, IN, CCN 150146

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jfortney@directaddress.net

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.

• Three Rivers Dermatology, LLC

  dba Three Rivers Dermatology

  • Specialist
  • Fort Wayne, IN
  • NPI 1992991475
  Medicare reassignment Care Compare group
• Sound Physicians of Indiana, LLC

  • Hospitalist Physician
  • Gary, IN
  • NPI 1528311149
  Medicare reassignment
• Hospitalist Medicine Physicians of Indiana, LLC

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1720416555

  IN

  Medicare reassignment
• Sound Physicians of Indiana, LLC

  dba Sound Physicinas of Indiana

  • Hospitalist Physician
  • Terre Haute, IN
  • NPI 1184063257
  NPD
• Emergency Medicine of Indiana LLC

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1881969418
  NPD (past)
• Innovative Hospital Care, LLC

  • Hospitalist Physician
  • Fort Wayne, IN
  • NPI 1922374172
  NPD (past)

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

• Community Hospital of Noble County, Inc.

  dba Parkview Noble Hospital

  • General Acute Care Hospital
  • Kendallville, IN
  • NPI 1457366189
  Care Compare affiliation

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1073963351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 COVENTRY LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047140",
            "telephone_number": "217-508-8478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5650 COVENTRY LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047140",
            "telephone_number": "217-508-8478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7950 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044140",
            "country_code": "US",
            "telephone_number": "260-435-7001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTNEY",
        "first_name": "JENIFER",
        "middle_name": "KAY",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10002104A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Edward Fortier, DMD
• Fortify Physical Therapy LLC
• Joseph D Fortin, D.O.
• Mary Elizabeth Fortman, N.P.
• Benjamin Philip Fortney, MD
• Samantha A Fortune, RBT
• Erin Fosnaugh, HIS
• Carin Elisabeth Foss, NP-BC, RN
• Stephanie Foss
• Foster Park Counseling LLC

• Medical Physician Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.

Verify at the official NPI Registry.