Individual provider Active NPI

Jennie Patel, PA

  • Physician Assistant
  • Corona, CA
National Provider Identifier
1508648106
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
341 Magnolia Ave Ste 101
Corona, CA 92879-3331
Phone
(951) 735-6060
Fax
(951) 735-4510
NPI assigned
Oct 18, 2023
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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 NU Primary

Addresses

Primary practice location

341 Magnolia Ave Ste 101
Corona, CA 92879-3331

Mailing address

341 Magnolia Ave Ste 101
Corona, CA 92879-3331
Phone (951) 735-6060

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
I20240508002212 CA Practitioner - Physician Assistant 4385085307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Boston University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Corona Orthopaedic Associates Medical Group IncGroup PAC ID 0547243586, 11 clinicians

Practice addresses (Care Compare)

341 Magnolia Ave
Corona, CA 92879-3331
Phone (209) 334-6583

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63577CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Health Services of Rancho Springs Inc Past Accepting new patients
Uhs Corona Inc Past Accepting new patients
Physicians' Hospital of Murrieta, LLC Past Accepting new patients
Temecula Valley Hospital Inc Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jpatel315677@direct.llu.edu

Organizations & group practices 5

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 1

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": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1508648106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 MAGNOLIA AVE STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793331",
            "telephone_number": "951-735-6060",
            "fax_number": "951-735-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 MAGNOLIA AVE STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793331",
            "telephone_number": "951-735-6060",
            "fax_number": "951-735-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JENNIE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.