Individual provider Active NPI

Jelena Dragoljevic, PA

  • Medical Physician Assistant
  • Roseville, CA
National Provider Identifier
1104606979
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
3400 Douglas Blvd Ste 170
Roseville, CA 95661-4281
Phone
(407) 435-5067
NPI assigned
Sep 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X FL Primary

Addresses

Primary practice location

3400 Douglas Blvd Ste 170
Roseville, CA 95661-4281

Mailing address

3400 Douglas Blvd Ste 170
Roseville, CA 95661-4281
Phone (407) 435-5067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240405003108 FL Practitioner - Physician Assistant 6002254257 Reassigns benefits to 1 organization
I20250813002242 CA Practitioner - Physician Assistant 6002254257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3400 Douglas Blvd
Suite 170
Roseville, CA 95661-4278

3400 Douglas Blvd
Suite 170
Roseville, CA 95661-4281

Hospital & facility affiliations

  • Sutter Coast Hospital Hospital, Crescent City, CA, CCN 050417

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tele-Medicine Services Ny, PLLC PastSince Apr 27, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: telemed2u.jelenadragoljevic@160918.advancedmd-direct.com

Organizations & group practices 3

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.

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": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1104606979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DOUGLAS BLVD STE 170",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614281",
            "telephone_number": "407-435-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 DOUGLAS BLVD STE 170",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614281",
            "telephone_number": "407-435-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAGOLJEVIC",
        "first_name": "JELENA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-29",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.