Individual provider Active NPI

Jennifer Ward

  • Medical Physician Assistant
  • Vacaville, CA
National Provider Identifier
1245208818
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
600 Nut Tree Rd Ste 260
Vacaville, CA 95687-4686
Phone
(707) 452-7222
Fax
(707) 452-8507
NPI assigned
Mar 9, 2006
Last updated
May 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601003292 MI
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

600 Nut Tree Rd Ste 260
Vacaville, CA 95687-4686

Mailing address

2290 Sacramento St
Vallejo, CA 94590-2929
Phone (707) 643-5785

Other practice location 1

2290 Sacramento St
Vallejo, CA 94590-2929
Phone (707) 643-5785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070322000097 MI Practitioner - Physician Assistant 3779687264
I20201015002468 CA Practitioner - Physician Assistant 3779687264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
71.3 of 100Reported as group
Quality
46
Improvement activities
40
Cost
76.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601003292MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Solano Dermatology Associates Inc CurrentSince Nov 1, 2020 Accepting new patients
Solano Dermatology Associates Inc Past Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

600 Nut Tree Rd
Ste 260
Vacaville, CA 95687
Phone (707) 259-1800

2290 Sacramento St
Vallejo, CA 94590
Phone (707) 643-5785

Interoperability endpoints

  • Direct secure messaging: jennifer.ward.p1@direct.solderm.nextgenshare.com

Organizations & group practices 4

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1245208818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 SACRAMENTO ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945902929",
            "telephone_number": "707-643-5785",
            "fax_number": "707-643-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NUT TREE RD STE 260",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956874686",
            "telephone_number": "707-452-7222",
            "fax_number": "707-452-8507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2290 Sacramento St",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945902929",
            "country_code": "US",
            "telephone_number": "707-643-5785",
            "fax_number": "707-643-8190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARD",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003292",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

Verify at the official NPI Registry.