Individual provider Active NPI

Kristin L Jochum, MPAS, PA-C

  • Physician Assistant
  • Lakewood Ranch, FL
National Provider Identifier
1376818427
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9106074 Issued in FL
Practice address
8926 77TH Ter E
Unit 101
Lakewood Ranch, FL 34202-6417
Phone
(941) 907-0222
NPI assigned
Mar 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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 PA 9106074 FL Primary

Addresses

Primary practice location

8926 77TH Ter E
Unit 101
Lakewood Ranch, FL 34202-6417

Mailing address

8926 77TH Ter E
Suite 101
Lakewood Ranch, FL 34202-6417
Phone (941) 907-0222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130829000568 FL Practitioner - Physician Assistant 6103069794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emily F Arsenault MD PAGroup PAC ID 9739106584, 24 clinicians

Practice addresses (Care Compare)

5860 Ranch Lake Blvd
Suite 103
Lakewood Ranch, FL 34202-3719
Phone (941) 907-0222

8926 77TH Ter E
Unit 101
Lakewood Ranch, FL 34202-6417
Phone (941) 907-0222

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9106074FLMDPhysician 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.

NPI Registry JSON

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1376818427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8926 77TH TER E",
            "address_2": "SUITE 101",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342026417",
            "telephone_number": "941-907-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8926 77TH TER E",
            "address_2": "UNIT 101",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342026417",
            "telephone_number": "941-907-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOCHUM",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-21",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9106074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

Verify at the official NPI Registry.