Jenni Hetletved, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1177 Border LN
Washburn, ND 58577-4102

Phone

(701) 462-3396

NPI assigned

Aug 28, 2023

Last updated

Aug 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jenni Ebert Former name

Medicare fee-for-service enrollment

Enrolled in ND

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

Specialty

Physician Assistant

Education

University of North Dakota School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Alexius Medical CenterGroup PAC ID 8426960865, shared by 12 NPIs, 239 clinicians

Garrison Memorial HospitalGroup PAC ID 0143206946, shared by 4 NPIs, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Garrison Memorial Hospital Hospital, Garrison, ND, CCN 351303
• CHI St Alexius Health Turtle Lake Hospital, Turtle Lake, ND, CCN 351304
• Garrison Memorial Hospital Nursing home, CCN 35Z303

Merit-based Incentive Payment System (MIPS)

Final score

83.48 of 100Reported as group

Quality

73.03

Promoting interoperability

100

Improvement activities

40

Cost

71.91

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Garrison Memorial Hospital

  dba Garrison Family Clinic

  • Rural Health Clinic/Center
  • Garrison, ND
  • NPI 1952381873
  Medicare reassignment NPD
• Garrison Memorial Hospital

  • Critical Access Hospital
  • Garrison, ND
  • NPI 1982674560
  Medicare reassignment NPD
• St. Alexius Medical Center

  dba CHI St. Alexius Health Turtle Lake

  • Critical Access Hospital
  • Turtle Lake, ND
  • NPI 1013961820
  Medicare reassignment NPD
• St. Alexius Medical Center

  dba CHI St. Alexius Health Clinics

  • Specialist
  • Bismarck, ND
  • NPI 1205868429
  Medicare reassignment NPD
• St Alexius Medical Center

  dba CHI St. Alexius Health

  • Home Infusion Therapy Pharmacy
  • Bismarck, ND
  • NPI 1063663607
  NPD
• St. Alexius Medical Center

  • Rural Health Clinic/Center
  • Washburn, ND
  • NPI 1831267236
  NPD
• Community Memorial Hospital

  • Internal Medicine Physician
  • Hamilton, NY
  • NPI 1932100393
  NPD (past)

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

• Garrison Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Garrison, ND
  • NPI 1861462442

  Nursing home

  Care Compare affiliation
• Garrison Memorial Hospital

  • Critical Access Hospital
  • Garrison, ND
  • NPI 1982674560
  Care Compare affiliation
• St. Alexius Medical Center

  dba CHI St. Alexius Health Turtle Lake

  • Critical Access Hospital
  • Turtle Lake, ND
  • NPI 1013961820
  Care Compare affiliation

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1164207338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 7TH ST",
            "city": "WASHBURN",
            "state": "ND",
            "postal_code": "585774384",
            "telephone_number": "701-200-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 BORDER LN",
            "city": "WASHBURN",
            "state": "ND",
            "postal_code": "585774102",
            "telephone_number": "701-462-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETLETVED",
        "first_name": "JENNI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNI",
            "last_name": "EBERT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alyce M Goetz
• Jill Renee Goven, FNP
• Jason Hahn, RPT
• Ryan Robert Hamrick
• Maurice Hardy, LSW
• Frederick Randolph Hinson
• Randall Paul Hojian
• Lisa Marie Holter, LPCC
• Sibashton Tre Holybear
• Jones Physical Therapy

• Physician Assistant in Washburn, ND
• Providers in Washburn, ND by specialty
• Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.