NPIMap

Individual provider Active NPI

Alejandra Medina Jimenez, PA

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1205311693
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3034 Issued in SC
Practice address
890 W Faris Rd Ste 310
Greenville, SC 29605-4281
Phone
(864) 455-8300
NPI assigned
Oct 1, 2018
Last updated
Jul 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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 3034 SC Primary

Addresses

Primary practice location

890 W Faris Rd Ste 310
Greenville, SC 29605-4281

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8617

Other practice location 1

313 Main St Ste B
Greenwood, SC 29646-2757
Phone (864) 547-8304

Other practice location 2

22725 Highway 76 E
Clinton, SC 29325-7527
Phone (864) 547-8304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20190306002823 SC Practitioner - Physician Assistant 1355680489 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

701 Grove Rd
Greenville, SC 29605-4210

890 W Faris Rd
Greenville, SC 29605-4281

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.33 of 100Reported as group
Quality
75.48
Promoting interoperability
100
Improvement activities
40
Cost
72.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3034SCMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jul 6, 2020 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 6, 2020 Accepting new patients
Carolina Health Centers, Inc. CurrentSince Jan 9, 2019 Accepting new patients
Carolina Health Centers, Inc. CurrentSince Jan 9, 2019 Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

890 W Faris Rd
Ste 310
Greenville, SC 29605
Phone (864) 455-8300

313 Main St
#A
Greenwood, SC 29646
Phone (864) 229-4446

313 Main St
#B
Greenwood, SC 29646

313 Main St
Ste B
Greenwood, SC 29646
Phone (864) 229-4446

Interoperability endpoints

  • Direct secure messaging: amedinajimenez244400@direct.ghs.myhfn.org

Organizations & group practices 6

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 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1205311693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 W FARIS RD STE 310",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054281",
            "telephone_number": "864-455-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "313 Main St Ste B",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296462757",
            "country_code": "US",
            "telephone_number": "864-547-8304",
            "fax_number": "864-938-2881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22725 Highway 76 E",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "SC",
            "postal_code": "293257527",
            "country_code": "US",
            "telephone_number": "864-547-8304",
            "fax_number": "864-938-2881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA JIMENEZ",
        "first_name": "ALEJANDRA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.