Madeline Jensen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1816 Salk Ave
Tavares, FL 32778-4300

Phone

(352) 343-2461

Fax

(352) 343-5968

NPI assigned

Aug 16, 2019

Last updated

Aug 21, 2020By 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 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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Leavitt Medical Associates of Florida IncGroup PAC ID 4688579311, 199 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology and Cosmetic Surq

  • Dermatology Physician
  • Sebastian, FL
  • NPI 1083872535
  Medicare reassignment Care Compare group NPD
• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology and Cosmetic Surgery

  • Dermatology Physician
  • St Petersburg, FL
  • NPI 1679731178
  NPD
• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology And Cosmetic Surgery

  • Dermatology Physician
  • Heathrow, FL
  • NPI 1528097284
  NPD (past)

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1659927390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 SALK AVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784300",
            "telephone_number": "352-343-2461",
            "fax_number": "352-343-5968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 SALK AVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784300",
            "telephone_number": "352-343-2461",
            "fax_number": "352-343-5968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Lee Rd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327892163",
            "country_code": "US",
            "telephone_number": "407-647-7300",
            "fax_number": "407-647-5496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "MADELINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Jacoby, FNP-C, PMHNP-BC
• Janice R Lorenzen MD LLC
• Yulei Elcin Jaramillo I
• Kelly Jennings, MH 21536
• Deborah Jensen-Short, LMHC
• Kegan Sherard Jessamy, MD
• Jest Operating Inc (Somerset Assisted Living Facility)
• John W. Cooke, D.O., P.a
• David Johnson Jr.
• Dione Jeannette Johnson, PT, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; 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.