Individual provider Active NPI

Jennifer Rendall, MS,PA-C

  • Medical Physician Assistant
  • North Brunswick, NJ
National Provider Identifier
1164675674
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00208600 Issued in NJ
Practice address
1950 Route 27
North Brunswick, NJ 08902-1300
Phone
(732) 297-8866
Fax
(732) 821-0626
NPI assigned
Oct 28, 2008
Last updated
Aug 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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 25MP00208600 NJ Primary

Addresses

Primary practice location

1950 Route 27
North Brunswick, NJ 08902-1300

Mailing address

208 Bunn Dr
Princeton, NJ 08540-2851
Phone (609) 683-4999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20090108000338 NJ Practitioner - Physician Assistant 1850454489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hunterdon Dermatology LLCGroup PAC ID 7113951856, 4 clinicians

Practice addresses (Care Compare)

6 N Main St
Flemington, NJ 08822-1154
Phone (908) 782-1647

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.16 of 100Reported as group
Quality
90.32
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00208600NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Dermatology Associates Kendall Parkpc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1164675674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 BUNN DR",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402851",
            "telephone_number": "609-683-4999",
            "fax_number": "609-683-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 ROUTE 27",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089021300",
            "telephone_number": "732-297-8866",
            "fax_number": "732-821-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENDALL",
        "first_name": "JENNIFER",
        "credential": "MS,PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00208600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.