NPIMap

Individual provider Active NPI

Jeanette L Nienaber, PA

  • Medical Physician Assistant
  • Seward, AK
National Provider Identifier
1134558984
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
104716 Issued in AK
Practice address
2035 Seward Hwy
Seward, AK 99664-9733
Phone
(907) 224-3490
Fax
(907) 802-4436
NPI assigned
Nov 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 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 104716 AK Primary

Addresses

Primary practice location

2035 Seward Hwy
Seward, AK 99664-9733

Mailing address

PO Box 2088
2035 Seward Highway
Seward, AK 99664-2088
Phone (907) 224-3490

Other identifiers 1

IdentifierTypeStateIssuer
1634651MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20151021002691 AK Practitioner - Physician Assistant 0446487847 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
ChugachmiutGroup PAC ID 0648161141, 9 clinicians

Practice addresses (Care Compare)

2035 Seward Hwy
Seward, AK 99664-2088
Phone (907) 224-3490

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11495MNMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: jnienaber556854@ak.providencedirect.org

Organizations & group practices 2

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1134558984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2088",
            "address_2": "2035 SEWARD HIGHWAY",
            "city": "SEWARD",
            "state": "AK",
            "postal_code": "996642088",
            "telephone_number": "907-224-3490",
            "fax_number": "907-802-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 SEWARD HWY",
            "city": "SEWARD",
            "state": "AK",
            "postal_code": "996649733",
            "telephone_number": "907-224-3490",
            "fax_number": "907-802-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIENABER",
        "first_name": "JEANETTE",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-02",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "104716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1634651",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seward, AK

Sources for this page

Verify at the official NPI Registry.