Individual provider Active NPI

Jennie Aufhauser, PA

  • Dermatology Physician
  • Santa Monica, CA
National Provider Identifier
1417130147
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
PA19475 Issued in CA
Practice address
2001 Santa Monica Blvd Ste 480W
Santa Monica, CA 90404-2121
Phone
(310) 954-9501
Fax
(310) 954-9502
NPI assigned
Dec 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X PA19475 CA Primary
Medical Physician Assistant 363AM0700X PA19475 CA

Addresses

Primary practice location

2001 Santa Monica Blvd Ste 480W
Santa Monica, CA 90404-2121

Mailing address

2001 Santa Monica Blvd Ste 480W
Santa Monica, CA 90404-2121
Phone (310) 954-9501

Other identifiers 1

IdentifierTypeStateIssuer
PA19475OtherCALICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170404001426 CA Practitioner - Physician Assistant 1759673643 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parrish Sadeghi, MD IncGroup PAC ID 5092953216, 4 clinicians

Practice addresses (Care Compare)

2001 Santa Monica Blvd
Suite 480W
Santa Monica, CA 90404-2121
Phone (310) 883-5508

Merit-based Incentive Payment System (MIPS)

Final score
98.01 of 100Reported as group
Quality
96.03
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19475CAMDChiropractor
PA19475CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1417130147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 480W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042121",
            "telephone_number": "310-954-9501",
            "fax_number": "310-954-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 480W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042121",
            "telephone_number": "310-954-9501",
            "fax_number": "310-954-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUFHAUSER",
        "first_name": "JENNIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-17",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "PA19475",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA19475",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PA19475",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.