Individual provider Active NPI

Jessica Lynn Mathenia, PA-C

  • Family Medicine Physician
National Provider Identifier
1568747822
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
106 Issued in VI
Practice address
6500 Red Hook Plaza
Suite 205
St Thomas, VI 00802
UM
Phone
(340) 775-2303
NPI assigned
Oct 19, 2011
Last updated
Aug 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085004185 IL
Medical Physician Assistant 363AM0700X 085004185 IL
Family Medicine Physician 207Q00000X 106 VI Primary

Addresses

Primary practice location

6500 Red Hook Plaza
Suite 205
St Thomas, VI 00802
UM

Mailing address

5000 Estate Enighed
PMB 214
St John, VI 00830
UM

Other practice location 1

104 Courthouse Sq
Toledo, IL 62468-1052
Phone (217) 849-3151

Other practice location 2

901 E Brady St
Butler, PA 16001-4648
Phone (724) 285-9200

Other names 1

  • Jessica Lynn Reuter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI
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
I20250416001811 VI Practitioner - Physician Assistant 1355516246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085004185ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yacht Haven Family Practice Family Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1568747822",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "5000 ESTATE ENIGHED",
            "address_2": "PMB 214",
            "city": "ST JOHN",
            "state": "VI",
            "postal_code": "00830"
        },
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "6500 RED HOOK PLAZA",
            "address_2": "SUITE 205",
            "city": "ST THOMAS",
            "state": "VI",
            "postal_code": "00802",
            "telephone_number": "340-775-2303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Courthouse Sq",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "IL",
            "postal_code": "624681052",
            "country_code": "US",
            "telephone_number": "217-849-3151",
            "fax_number": "217-849-3123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 E Brady St",
            "address_purpose": "LOCATION",
            "city": "Butler",
            "state": "PA",
            "postal_code": "160014648",
            "country_code": "US",
            "telephone_number": "724-285-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHENIA",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004185",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085004185",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VI",
            "license": "106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "REUTER",
            "middle_name": "LYNN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Sources for this page

Verify at the official NPI Registry.