Jennifer Pandolfi, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9114043 Issued in FL

Practice address

7552 Navarre Pkwy Unit 10
Navarre, FL 32566-7312

Phone

(850) 939-8474

Fax

(850) 939-8475

NPI assigned

Mar 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

Practice roles

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.

• Paul J Pandolfi, M.D.

  • Family Medicine Physician
  • Navarre, FL
  • NPI 1982660023
  Medicare reassignment
• Paul J Pandolfi

  • Family Medicine Physician
  • Navarre, FL
  • NPI 1396137485
  NPD (past)

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1619552809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7552 NAVARRE PKWY UNIT 10",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325667312",
            "telephone_number": "850-939-8474",
            "fax_number": "850-939-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7552 NAVARRE PKWY UNIT 10",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325667312",
            "telephone_number": "850-939-8474",
            "fax_number": "850-939-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDOLFI",
        "first_name": "JENNIFER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Navarre, FL
• Providers in Navarre, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.