Individual provider Active NPI

Jennifer Brynn Bendokas, PA-C

  • Physician Assistant
  • Alexandria, VA
National Provider Identifier
1396155206
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9114125 Issued in FL
Practice address
6355 Walker Lane
Suite 308
Alexandria, VA 22310-3247
Phone
(703) 313-7700
NPI assigned
Apr 30, 2014
Last updated
Aug 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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 PA9114125 FL Primary

Addresses

Primary practice location

6355 Walker Lane
Suite 308
Alexandria, VA 22310-3247

Mailing address

6355 Walker LN Ste 308
Alexandria, VA 22310-3247
Phone (703) 313-7700

Other identifiers 2

IdentifierTypeStateIssuer
1396155206MedicaidVA
30018661770001MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, DC2 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

Enrollment IDStateProvider typePAC IDDetails
I20230119002003 FL Practitioner - Physician Assistant 0547567323 Reassigns benefits to 1 organization
I20260620000183 DC Practitioner - Physician Assistant 0547567323

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

310 Racetrack Rd NW
Fort Walton Beach, FL 32547-1553
Phone (850) 889-4550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9114125FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Jun 3, 2024 Accepting new patients
North Florida Surgeons, PA CurrentSince Jun 3, 2024 Accepting new patients

Locations

310 Racetrack Rd NW
Fort Walton Beach, FL 32547
Phone (850) 889-4550

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

Interoperability endpoints

  • Direct secure messaging: jennifer.bendokas.1@9109.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1396155206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 WALKER LN STE 308",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103247",
            "telephone_number": "703-313-7700",
            "fax_number": "703-313-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 WALKER LANE",
            "address_2": "SUITE 308",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103247",
            "telephone_number": "703-313-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDOKAS",
        "first_name": "JENNIFER",
        "middle_name": "BRYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396155206",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30018661770001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.