Active NPI
Jenna Mullett
- Physician Assistant
- West Seneca, NY
National Provider Identifier
1306419700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 026852
- Practice address
- 1956 Ridge Rd
West Seneca, NY 14224-3312 - Phone
- (716) 844-9278
- NPI assigned
- Jul 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 026852 | NY | |
| Physician Assistant | 363A00000X | 026852 | NY | Primary |
Addresses
Primary practice location
1956 Ridge Rd
West Seneca, NY 14224-3312
Mailing address
7375 Oswego Rd
Liverpool, NY 13090-3717
Phone (716) 844-9278
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
225 S Cascade Dr
Springville, NY 14141-9275
Phone (716) 599-1163
7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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.
-
- Urgent Care Clinic/Center
- Liverpool, NY
- NPI 1669825162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663286400000",
"number": "1306419700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7375 OSWEGO RD",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130903717",
"telephone_number": "716-844-9278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1956 RIDGE RD",
"city": "WEST SENECA",
"state": "NY",
"postal_code": "142243312",
"telephone_number": "716-844-9278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLETT",
"first_name": "JENNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-22",
"last_updated": "2022-09-16",
"certification_date": "2022-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "026852",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "026852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Seneca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.