Kelly M Jensen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601003267 Issued in MI

Practice address

6401 Prairie St
Suite 2300
Norton Shores, MI 49444-7840

Phone

(231) 727-7928

Fax

(231) 724-7844

NPI assigned

Oct 2, 2006

Last updated

Jul 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Specialty ServicesGroup PAC ID 2365439544, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

97.08

Improvement activities

40

Cost

74.32

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kjensen36569@direct.trinity-health.org

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.

• Mercy Specialty Services

  dba Trinity Health Medical Group

  • Internal Medicine Physician
  • Muskegon, MI
  • NPI 1629010384
  Medicare reassignment Care Compare group
• Mercy Health Partners

  dba Trinity Health Medical Group

  • Certified Registered Nurse Anesthetist
  • Shelby, MI
  • NPI 1154910172
  NPD (past)
• Mercy Health Partners - Physician Specialist

  dba Trinity Health Medical Group

  • Internal Medicine Physician
  • Muskegon, MI
  • NPI 1922248772

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Health Partners

  dba Mercy Health Muskegon

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1326131335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431847",
            "telephone_number": "231-727-7948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 PRAIRIE ST",
            "address_2": "SUITE 2300",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494447840",
            "telephone_number": "231-727-7928",
            "fax_number": "231-724-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003267",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601003267",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "N34010012",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Nicole Jahnke
• Annika Jaros
• Krystle Monique' Jefferson
• John Jendrasiak
• Davis Jennings
• Caitlin Elizabeth Jimerson, LMSW
• Amber Lynn Johnson, LLMSW
• Michael Johnson
• Monique Johnson, SLP
• Rhiley Johnson, OTD, OTR/L

• Physician Assistant in Norton Shores, MI
• Providers in Norton Shores, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.

Verify at the official NPI Registry.