Individual provider Active NPI

Jenna Nicole Radvansky, PA

  • Physician Assistant
  • Steubenville, OH
National Provider Identifier
1154987154
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.006042RX Issued in OH
Practice address
4100 Johnson Rd Ste 100
Steubenville, OH 43952-2356
Phone
(740) 264-8600
Fax
(740) 346-0298
NPI assigned
May 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 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 50.006042RX OH Primary

Addresses

Primary practice location

4100 Johnson Rd Ste 100
Steubenville, OH 43952-2356

Mailing address

380 Summit Avenue
Mso Physician Billing
Steubenville, OH 43952-2667
Phone (740) 283-7597

Other identifiers 1

IdentifierTypeStateIssuer
0358704MedicaidOH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190813003122 OH Practitioner - Physician Assistant 6608103643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity WestGroup PAC ID 5496648875, 145 clinicians

Practice addresses (Care Compare)

107 Main St
Wintersville, OH 43953-3733
Phone (740) 264-1656

4100 Johnson Rd
Steubenville, OH 43952-2356

Hospital & facility affiliations

  • Trinity Medical Ctr East &Trinity Medical Ctr West Hospital, Steubenville, OH, CCN 360211

Merit-based Incentive Payment System (MIPS)

Final score
73.74 of 100Reported as group
Quality
48.02
Promoting interoperability
91
Improvement activities
40
Cost
71.96

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity West CurrentSince Jul 11, 2019 Accepting new patients

Locations

4100 Johnson Rd
Ste 100
Steubenville, OH 43952
Phone (740) 264-8600

380 Summit Ave
Steubenville, OH 43952
Phone (740) 283-7000

107 Main St
Wintersville, OH 43953
Phone (740) 264-1656

4000 Johnson Rd
Wintersville, OH 43952
Phone (740) 264-8011

Interoperability endpoints

  • Direct secure messaging: jenna.ogden@tpg.eclinicaldirectplus.com

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 1

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": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1154987154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 SUMMIT AVENUE",
            "address_2": "MSO PHYSICIAN BILLING",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "439522667",
            "telephone_number": "740-283-7597",
            "fax_number": "740-283-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHNSON RD STE 100",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "439522356",
            "telephone_number": "740-264-8600",
            "fax_number": "740-346-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADVANSKY",
        "first_name": "JENNA",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006042RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0358704",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Steubenville, OH

Sources for this page

Verify at the official NPI Registry.