Individual provider Active NPI

Jennifer Bievenue

  • Physician Assistant
  • Altamont, NY
National Provider Identifier
1124819982
Registry record updated Aug 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
034140 Issued in NY
Practice address
2508 Western Ave
Altamont, NY 12009-9485
Phone
(518) 690-0177
NPI assigned
May 13, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 034140 NY Primary

Addresses

Primary practice location

2508 Western Ave
Altamont, NY 12009-9485

Mailing address

2508 Western Ave
Altamont, NY 12009-9485
Phone (518) 690-0177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250822003972 NY Practitioner - Physician Assistant 7315447422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schweiger Dermatology PLLCGroup PAC ID 5991947160, 254 clinicians

Practice addresses (Care Compare)

2500 Western Ave
Altamont, NY 12009-9485
Phone (518) 690-0177

2508 Western Ave
Altamont, NY 12009-9485
Phone (518) 690-0177

National Provider Directory

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

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 1

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": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754179200000",
    "number": "1124819982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 WESTERN AVE",
            "city": "ALTAMONT",
            "state": "NY",
            "postal_code": "120099485",
            "telephone_number": "518-690-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 WESTERN AVE",
            "city": "ALTAMONT",
            "state": "NY",
            "postal_code": "120099485",
            "telephone_number": "518-690-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIEVENUE",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-08-03",
        "certification_date": "2025-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamont, NY

Sources for this page

Verify at the official NPI Registry.