Individual provider Active NPI

Jennie Frenkel

  • Medical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1558089821
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
11067 Issued in GA
Practice address
1100 Lake Hearn Dr
Atlanta, GA 30342-1523
Phone
(404) 365-0966
NPI assigned
Aug 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 11067 GA Primary

Addresses

Primary practice location

1100 Lake Hearn Dr
Atlanta, GA 30342-1523

Mailing address

3464 Roxboro Rd NE Unit 2405
Atlanta, GA 30326-3399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240417003187 GA Practitioner - Physician Assistant 1153760509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

200 Crescent Ctr Pkwy
Tucker, GA 30084-7047
Phone (404) 365-0966

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

3650 Steve Reynolds Blvd
Duluth, GA 30096-4506
Phone (770) 931-6026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1558089821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3464 ROXBORO RD NE UNIT 2405",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303263399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAKE HEARN DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421523",
            "telephone_number": "404-365-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRENKEL",
        "first_name": "JENNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "11067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.