Jennifer Tallis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C5-0000790 Issued in DE

Practice address

4755 Ogletown Stanton Rd
Newark, DE 19718-0001

Phone

(302) 733-1000

NPI assigned

Oct 15, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE, MD2 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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Union Hospital of Cecil CountyGroup PAC ID 6901719822, 281 clinicians

Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christiana Hospital Hospital, Newark, DE, CCN 080001
• Union Hospital of Cecil County Hospital, Elkton, MD, CCN 210032

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Christiana Care Health Services Inc

  • Pulmonary Disease Physician
  • Newark, DE
  • NPI 1255618070
  Medicare reassignment Care Compare group NPD
• Union Hospital of Cecil County

  • Internal Medicine Physician
  • Elkton, MD
  • NPI 1124067848
  Medicare reassignment Care Compare group NPD
• Christiana Care Health Services Inc

  • Neurology Physician
  • Chadds Ford, PA
  • NPI 1881228484
  NPD
• Union Hospital of Cecil County, Inc.

  • Urology Physician
  • Elkton, MD
  • NPI 1407607450
  NPD
• Christiana Care Health Services, Inc

  • Family Medicine Physician
  • Hockessin, DE
  • NPI 1134104565
  NPD (past)

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

• Christiana Care Health Services, Inc.

  • General Acute Care Hospital
  • Wilmington, DE
  • NPI 1134194038
  Care Compare affiliation
• Union Hospital of Cecil County

  • General Acute Care Hospital
  • Elkton, MD
  • NPI 1376523357
  Care Compare affiliation

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

{
    "created_epoch": "1318636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318636800000",
    "number": "1356626865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834 LOVERING AVE",
            "address_2": "APT 2",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198062122",
            "telephone_number": "845-642-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197180001",
            "telephone_number": "302-733-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLIS",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-15",
        "last_updated": "2011-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DE",
            "license": "C5-0000790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debbie D. Takats, RN
• Take Care Health Delaware, P.a.
• Yoav J Tal, M.D.
• Lasya Tallapragada
• Lynn E Talley, D.O.
• Beltus N Tamiah
• Ching-Hsuan Tang
• Nathaniel Freeman Tanner, PA-C
• Jessica Marie Tansey, FNP
• Trinity Lissette Tapper

• Medical Physician Assistant in Newark, DE
• Providers in Newark, DE by specialty
• Medical Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2011; 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.