Individual provider Active NPI

Jennifer Tanner, PAC

  • Medical Physician Assistant
  • Mechanicsburg, PA
National Provider Identifier
1215998554
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA003145L Issued in PA
Practice address
175 Lancaster Blvd
Mechanicsburg, PA 17055
Phone
(717) 691-3755
Fax
(717) 691-3834
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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 MA003145L PA Primary

Addresses

Primary practice location

175 Lancaster Blvd
Mechanicsburg, PA 17055

Mailing address

1776 Woodstead CT Ste 208
The Woodlands, TX 77380-1480
Phone (877) 749-7428

Other identifiers 4

IdentifierTypeStateIssuer
103628397-0003MedicaidPA
103628397-0002MedicaidPA
103628397-0004MedicaidPA
103628397-0001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110331000178 PA Practitioner - Physician Assistant 6608059407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Post-Acute Physicians of Pennsylvania PLLCGroup PAC ID 3870806615, 8 clinicians

Practice addresses (Care Compare)

175 Lancaster Blvd
Mechanicsburg, PA 17055-3562
Phone (717) 691-4996

700 Walnut Bottom Rd
Carlisle, PA 17013-3631
Phone (717) 960-7700

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1215998554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 WOODSTEAD CT STE 208",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773801480",
            "telephone_number": "877-749-7428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 LANCASTER BLVD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "17055",
            "telephone_number": "717-691-3755",
            "fax_number": "717-691-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JENNIFER",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA003145L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103628397-0003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103628397-0002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103628397-0004",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103628397-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsburg, PA

Sources for this page

Verify at the official NPI Registry.