Susan E Jensen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10003480 Issued in WA

Practice address

5781 Main St
Springfield, OR 97478-5426

Phone

(541) 654-0282

NPI assigned

Sep 29, 2006

Last updated

Mar 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Susan E Small Former name

Medicare fee-for-service enrollment

Enrolled in WA, OR2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Icco, LLC

  dba BestMed

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  Medicare reassignment NPD
• Providence Health & Services Washington

  dba Providence Medical Group

  • Pulmonary Disease Physician
  • Spokane, WA
  • NPI 1194099390
  Medicare reassignment NPD
• Icco LLC

  dba BestMed

  • Rural Health Clinic/Center
  • Florence, OR
  • NPI 1740896547
  NPD
• Icco, LLC

  dba Veneta Medical Clinic

  • Family Medicine Physician
  • Veneta, OR
  • NPI 1518990621
  NPD
• Providence Health & Services Washington

  dba Providence North East Washington Medical Group

  • Family Medicine Physician
  • Colville, WA
  • NPI 1083968879
  NPD
• U.S. Healthworks Medical Group of Washington, PS

  • Urgent Care Clinic/Center
  • Valencia, CA
  • NPI 1407836208
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1528150927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5781 MAIN ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974785426",
            "telephone_number": "541-654-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "SUSAN",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003480",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10003480",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "SMALL",
            "middle_name": "E",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffeny Anne Jennings, RN
• Julian Jennison, LMT
• Amber Jensen
• Gillian A Jensen, RPH, BS
• Joan M Jensen, M.D.
• Ingrid Marta Jenson, LPN
• Paula H. Jewett, MD
• Ling Jin
• Joanna M Gervais OD LLC (Custom Eyes)
• Finn Jeffrey Joehnk, M.D.

• Physician Assistant in Springfield, OR
• Providers in Springfield, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.