Individual provider Active NPI

Jessica Raye Jensen, PAC

  • Physician Assistant
  • Anchorage, AK
National Provider Identifier
1275012908
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
155221 Issued in AK
Practice address
1200 W Northern Lights Blvd Ste B
Anchorage, AK 99503-3652
Phone
(907) 212-5165
Fax
(907) 212-0950
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 155221 AK Primary

Addresses

Primary practice location

1200 W Northern Lights Blvd Ste B
Anchorage, AK 99503-3652

Mailing address

PO Box 5517
Portland, OR 97228-5517
Phone (252) 075-1554

Other practice location 1

300 E Dimond Blvd Ste 300
Anchorage, AK 99515-1947
Phone (907) 341-7757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20200715000654 AK Practitioner - Physician Assistant 5294158465 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alaska Medical Clinics LLCGroup PAC ID 3274617253, 9 clinicians
Alaska Urgent Care LLCGroup PAC ID 1355574484, 13 clinicians

Practice addresses (Care Compare)

1700 E Parks Hwy
Suite 200
Wasilla, AK 99654-7361
Phone (907) 373-6055

300 E Dimond Blvd
Suite 12
Anchorage, AK 99515-1948
Phone (907) 341-7757

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
155221AKMDPhysician Assistant

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 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": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1275012908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5517",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972285517",
            "telephone_number": "252-075-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W NORTHERN LIGHTS BLVD STE B",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033652",
            "telephone_number": "907-212-5165",
            "fax_number": "907-212-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 E Dimond Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995151947",
            "country_code": "US",
            "telephone_number": "907-341-7757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "JESSICA",
        "middle_name": "RAYE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "155221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.