Jennifer Crystal Lievanos, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

54695 Issued in CA

Practice address

4234 Riverwalk Pkwy Ste 230
Riverside, CA 92505-3312

Phone

(951) 781-3672

NPI assigned

Sep 7, 2017

Last updated

Sep 7, 2017By the provider in NPPES

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

El-Bershawi Medical CorpGroup PAC ID 9032298492, 44 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

73.59 of 100Reported as group

Quality

52.13

Improvement activities

40

Cost

66.42

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.lievanos.p1@direct.pacificpulm.nextgenshare.com

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.

• El-Bershawi Medical Corp

  dba Pacific Pulmonary Medical Group

  • Critical Care Medicine (Internal Medicine) Physician
  • Riverside, CA
  • NPI 1386813103
  Medicare reassignment Care Compare group
• Pacific Professional Surgical Group Inc

  • Trauma Surgery Physician
  • Riverside, CA
  • NPI 1578341608
  NPD

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504742400000",
    "number": "1659899813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 RIVERWALK PKWY STE 230",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053312",
            "telephone_number": "951-781-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4234 RIVERWALK PKWY STE 230",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053312",
            "telephone_number": "951-781-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEVANOS",
        "first_name": "JENNIFER",
        "middle_name": "CRYSTAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2017-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marsha Andrea Liem
• Christina Lien
• Mary Lien, M.D.
• Susan Fai Lien, M.D.
• Lieu Rupp, M.D. Inc.
• Life Arts Counseling Center
• Life Enhancement Center
• Life Source Solutions, Inc
• Life Source Training Institute Inc
• Lifehouse Riverside Operations, LLC. (Riverside Healthcare Center)

• Physician Assistant in Riverside, CA
• Providers in Riverside, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.