Jennifer Ward Pucci, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95018543 Issued in CA

Practice address

4077 5TH Ave
San Diego, CA 92103-2105

Phone

(619) 686-3800

NPI assigned

Sep 30, 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 CA

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

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Pacific Emergency Providers, a Prof. Corp.

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1497790539
  Medicare reassignment NPD

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1649942467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 WASHINGTON ST # 844",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032110",
            "telephone_number": "619-203-7190",
            "fax_number": "858-675-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4077 5TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032105",
            "telephone_number": "619-686-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCCI",
        "first_name": "JENNIFER",
        "middle_name": "WARD",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95018543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PT Medical Consulting & Billing, LLC
• Sadell Ptomey
• Angelina Pua, PT
• Public Health Services-San Diego County
• Laurie Downs Publicover, M.D.
• Randi Pucely
• Daniel Puchala
• Benjamin Puckett, DIVE IDC
• Megan Puckett
• Michael L Puckett, MD

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.