Jennifer K Peck, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

1072660 Issued in OH

Practice address

3401 Enterprise Pkwy
Suite 300
Beachwood, OH 44122-7341

Phone

(216) 831-5700

NPI assigned

Oct 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: jpeck122107@direct.chmca.org

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.

• Retina Associates of Cleveland, Inc.

  • Retina Specialist (Ophthalmology) Physician
  • Beachwood, OH
  • NPI 1912991225
  Medicare reassignment
• Akron Children's Hospital

  • Children's Hospital
  • Akron, OH
  • NPI 1942465752
  NPD
• Children's Hospital Medical Center of Akron

  dba Akron Children's Hospital-Physician Group

  • Pediatrics Physician
  • Akron, OH
  • NPI 1841328853
  NPD (past)
• Retina Associates of Cleveland

  • Physician Assistant
  • Cleveland, OH
  • NPI 1841697463
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154407757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 ENTERPRISE PKWY",
            "address_2": "SUITE 300",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441227341",
            "telephone_number": "216-831-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 ENTERPRISE PKWY",
            "address_2": "SUITE 300",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441227341",
            "telephone_number": "216-831-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "1072660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearl's Hope, LLC
• Carol Pearson Stocchi, M.D.
• Naomi Pearson
• Jarrett Pease, DPT
• Marla Pease, OTR/L
• Pediatric Partners of Cleveland, Inc.
• Pediatric Place, Inc
• Gabriele Pedicelli, M.D.
• Karen Peereboom, CNP
• Brittany Peleg

• Surgical Physician Assistant in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Surgical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.