Individual provider Active NPI

Beverly Michelle Jennings, PHYSICIAN ASSISTANT

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1659961936
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60207 Issued in CA
Practice address
3180 University Ave Ste 120
San Diego, CA 92104-2046
Phone
(858) 554-1212
NPI assigned
Jan 21, 2021
Last updated
Aug 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60207 CA Primary
Medical Physician Assistant 363AM0700X
Surgical Physician Assistant 363AS0400X

Addresses

Primary practice location

3180 University Ave Ste 120
San Diego, CA 92104-2046

Mailing address

1111 Cumberland Rd
Chattanooga, TN 37419-1005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210325001081 TN Practitioner - Physician Assistant 8820405558 Reassigns benefits to 1 organization
I20210329001574 GA Practitioner - Physician Assistant 8820405558 Reassigns benefits to 1 organization
I20230224002028 CA Practitioner - Physician Assistant 8820405558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

Practice addresses (Care Compare)

3180 University Ave
Suite 120
San Diego, CA 92104-2046
Phone (858) 554-1212

3737 Moraga Ave
Suite B103
San Diego, CA 92117-5352
Phone (858) 799-0855

3900 5TH Ave
Suite 110
San Diego, CA 92103-3122
Phone (858) 554-1212

Merit-based Incentive Payment System (MIPS)

Final score
92.17 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
73.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60207CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Emergency Medicine PLLC CurrentSince Mar 1, 2021 Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients

Locations

100 Gross Crescent Cir
Ft Oglethorpe, GA 30742
Phone (706) 858-2301

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1659961936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 CUMBERLAND RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374191005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 UNIVERSITY AVE STE 120",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921042046",
            "telephone_number": "858-554-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "BEVERLY",
        "middle_name": "MICHELLE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60207",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.