Individual provider Active NPI

Jessica Marie Pflibsen

  • Physician Assistant
  • San Clemente, CA
National Provider Identifier
1265907935
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
905 Calle Amanecer Ste 115
San Clemente, CA 92673-6226
Phone
(949) 207-3603
NPI assigned
Oct 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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 Primary

Addresses

Primary practice location

905 Calle Amanecer Ste 115
San Clemente, CA 92673-6226

Mailing address

905 Calle Amanecer Ste 115
San Clemente, CA 92673-6226
Phone (949) 207-3603

Other practice location 1

2575 Yorba Linda Blvd
Fullerton, CA 92831-1615
Phone (714) 449-7400

Other practice location 2

204 S Santa Fe Ave
Vista, CA 92084-6002
Phone (760) 941-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20201028001129 CA Practitioner - Physician Assistant 8628498474 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
HMTS IncGroup PAC ID 1951750413, 118 clinicians

Practice addresses (Care Compare)

24060 Camino del Avion
Suite a
Dana Point, CA 92629-4006
Phone (949) 557-0870

26671 Aliso Creek Rd
Suite 101
Aliso Viejo, CA 92656-4807
Phone (949) 791-3107

26672 Portola Pkwy
Suite 100
Foothill Ranch, CA 92610-1773
Phone (949) 557-0710

31951 Dove Canyon Dr
Trabuco Canyon, CA 92679-3749
Phone (949) 557-0880

49000 Barranca Pkwy
Suite 103
Irvine, CA 92604-8603
Phone (949) 791-3106

8607 Irvine Ctr Dr
Irvine, CA 92618-4219
Phone (949) 557-0600

993 Avenida Pico
San Clemente, CA 92673-3908
Phone (949) 557-0400

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Merit-based Incentive Payment System (MIPS)

Final score
85.87 of 100Reported as group
Quality
84.39
Promoting interoperability
100
Improvement activities
40
Cost
68.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57624CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Hospital Past Accepting new patients

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 and National Provider Directory roles.

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": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1265907935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 CALLE AMANECER STE 115",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736226",
            "telephone_number": "949-207-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 CALLE AMANECER STE 115",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736226",
            "telephone_number": "949-207-3603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2575 Yorba Linda Blvd",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928311615",
            "country_code": "US",
            "telephone_number": "714-449-7400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "204 S Santa Fe Ave",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920846002",
            "country_code": "US",
            "telephone_number": "760-941-8888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PFLIBSEN",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2021-08-04",
        "certification_date": "2021-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.