Individual provider Active NPI

Jenna Rayanne Veres, PA-C

  • Emergency Medicine Physician
  • Cleveland, OH
National Provider Identifier
1619512407
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
50.006051 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone
(216) 444-0181
NPI assigned
Nov 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9083 MA
Emergency Medicine Physician 207P00000X 50.006051 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-0001

Mailing address

6944 N Renwood Rd
Independence, OH 44131-5318
Phone (216) 645-0211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20230201001111 MA Practitioner - Physician Assistant 1658706015 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Physician Services LLCGroup PAC ID 1456348127, 15 clinicians

Practice addresses (Care Compare)

554 Main St
Worcester, MA 01608-2062
Phone (413) 301-6019

95 Frank B Murray St
Springfield, MA 01103-1106
Phone (413) 301-6019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.006051OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Help Chelmsford PC CurrentSince Aug 1, 2023 Accepting new patients
Brockton Hospital, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Brockton Hospital, Inc. CurrentSince Jan 1, 2023 Accepting new patients

Locations

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

45 Drum Hill Rd
Chelmsford, MA 01824
Phone (978) 446-7515

Organizations & group practices 6

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": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1619512407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6944 N RENWOOD RD",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441315318",
            "telephone_number": "216-645-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERES",
        "first_name": "JENNA",
        "middle_name": "RAYANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9083",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "50.006051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.