Jeffrey C Renna, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA 153839 Issued in OR

Practice address

1011 Commercial St NE Ste 110
Salem, OR 97301-1036

Phone

(503) 983-9900

Fax

(503) 983-9899

NPI assigned

Dec 4, 2007

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in OR

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clear Choice DermatologyGroup PAC ID 4789005034, 47 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Clear Choice Dermatology

  • Dermatology Physician
  • The Dalles, OR
  • NPI 1891327185
  Medicare reassignment Care Compare group
• Victor R. Michalak

  • Ambulatory Surgical Clinic/Center
  • Issaquah, WA
  • NPI 1104877976
  NPD (past)

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1447432190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 COMMERCIAL ST NE STE 110",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011036",
            "telephone_number": "503-983-9900",
            "fax_number": "503-983-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 COMMERCIAL ST NE STE 110",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011036",
            "telephone_number": "503-983-9900",
            "fax_number": "503-983-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNA",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-04",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA 153839",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60133630",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500637318",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "384377",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia Eileen Remillard, RN
• Kaegan L Remington
• Whittley O Remington, BSN, RN
• Renaissance Recovery Resources, Inc.
• Renew Weight Loss LLC
• Brett Renquist, D.C., L.AC
• John O Renquist, DR OF CHIROPRACTIC
• Teresa Renshaw
• Karla Renteria
• Retina Consultants, LLP

• Medical Physician Assistant in Salem, OR
• Providers in Salem, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.