NPIMap

Individual provider Active NPI

Jessica Tanner, PA-C

  • Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1124577416
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5716 Cleveland St Ste 200
Virginia Beach, VA 23462-1784
Phone
(757) 490-4802
NPI assigned
Sep 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

5716 Cleveland St Ste 200
Virginia Beach, VA 23462-1784

Mailing address

5716 Cleveland St Ste 200
Virginia Beach, VA 23462-1784
Phone (757) 490-4802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161229000011 NJ Practitioner - Physician Assistant 1951682285 Reassigns benefits to 1 organization
I20190826003764 VA Practitioner - Physician Assistant 1951682285 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bethesda Chevy Chase Orthopaedic Associates, LLCGroup PAC ID 4789631011, 138 clinicians

Practice addresses (Care Compare)

5716 Cleveland St
Suite 200
Virginia Beach, VA 23462-1784
Phone (757) 490-4802

Hospital & facility affiliations

  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Bon Secours Maryview Medical Center Hospital, Portsmouth, VA, CCN 490017
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Riverside Shore Memorial Hospital Hospital, Onancock, VA, CCN 490037

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as individual
Quality
70.92
Promoting interoperability
100
Improvement activities
40
Cost
74.82

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bethesda Chevy Chase Orthopaedic Associates, LLC CurrentSince Jan 1, 2024 Accepting new patients
Bethesda Chevy Chase Orthopaedic Associates, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

5716 Cleveland St
Ste 200
Virginia Beach, VA 23462
Phone (757) 502-8583

Organizations & group practices 4

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1124577416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 CLEVELAND ST STE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621784",
            "telephone_number": "757-490-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5716 CLEVELAND ST STE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621784",
            "telephone_number": "757-490-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.